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Risk factors, clinical characteristics and mortality of candidemia in non-neutropenic, critically ill patients in a tertiary care hospital

Aim: In recent years candida species have emerged as important nosocomial pathogens leading to increased mortality and prolonged hospitalization. In this study, we aimed to determine the distribution of Candida species in the intensive care unit (ICU) and to investigate the risk factors and mortality rates in Candida albicans (CA) and non-albicans Candida infections (NAC). Methods: This retrospective cohort study was conducted between January 2018 and January 2019. 134 patients hospitalized in the intensive care units with Candida reproduction in their blood cultures were included in the study. Blood cultures were processed, and strain distribution was performed according to routine practice using the automated blood culture system BACTEC 9240 (Becton Dickinson, Maryland, USA). Results: Candida growth was detected in the blood culture of 134 patients, among which 54.5% consisted of CA and 45.5% of NAC. NAC was most commonly followed by C. parapsilosis (17.2%), and C. glabrata (13.4%). Mortality rate of patients aged ≥60 years was significantly higher in all three candida species (P=0.003). NAC was seen at an insignificantly higher rate in patients with solid-organ malignancy (P=0.09). Although mortality was higher in CA than NAC strain (53.6% and 43.4%, respectively), this was not statistically significant (P=0.83). Conclusion: Although CA is still the most common strain in ICU patients, the incidence of NAC is increasing. Candidemia has high mortality rates in ICU patients. Especially elderly patients with underlying diseases should be followed carefully.