A retrospective study between 2012-2019: Epidemiology of Candida infections in intensive care units

Candida, the most common causative agent among fungal infections, is associated with high mortality, morbidity, and increased costs. Early diagnosis and effective treatment planning are crucial for patient prognosis. This study aimed to retrospectively evaluate candida infections in adult intensive care units (ICU). Between January 2012 and May 2019, 373 patients with clinical and laboratory diagnoses of Candida infection who were hospitalized in the adult ICUs of Kahramanmaraş Sütçü İmam Faculty of Medicine University were included in our study. In this retrospective study, data of patients related to age, gender, hospitalization clinic, length of hospitalization, comorbidities, invasive and non-invasive procedures were recorded. Of the patients included in the study, 52.8% (197) were female and 47.2% (176) were male, with a mean age of 68.7±17.4 years. Of the isolated samples, 200 (53.6%) were Candida albicans and 173 (46.4%) were non-albicans Candida (NAC). There were significant differences between C. albicans and NAC groups in the presence of urinary catheter (p=.046), central venous catheter (p=.028), enteral nutrition (p=.026), and length of hospitalization (p=.047). The mean Candida score was 2.34±0.06 and patients with higher candida scores had a higher mortality rate (p<.001). The mortality rate was 68.1%. The advanced age, duration of hospitalization, use of total parenteral nutrition, presence of a central venous catheter, and sepsis/septic shock were found to be independent risk factors for mortality. Candida infections have high mortality and morbidity. Data on Candida epidemiology vary regionally and the initiation of effective empirical treatment in these infections directly affects the prognosis. Therefore, data on species distribution and antifungal resistance rates in each hospital will guide physicians in terms of patient management.