Persistent candidemia caused by different Candida species: Data from a multicenter contemporary cohort - 12/09/25
, Claudia Bartalucci b, c, Matteo Cerchiaro b, c, Mario Cesaretti a, Anna Marchese d, e, Vincenzo Di Pilato d, e, Pilar Escribano f, g, h, i, Arianna Forniti a, Daniele Roberto Giacobbe b, c, Jesus Guinea f, g, h, i, Alessandro Limongelli b, c, Antonella Lupetti j, Marina Machado f, g, h, Malgorzata Mikulska b, c, Jon Salmanton-García k, l, m, n, Ana Soriano-Martin f, g, h, Lucia Taramasso b, c, Maricela Valerio f, g, h, o, Emilio Bouza f, g, h, o, Patricia Muñoz f, g, h, o, Marco Falcone aon behalf of ESCMID Fungal Infection Study Group (EFISG)
Summary |
Objectives |
To explore persistent candidemia by different Candida spp.
Methods |
Observational, retrospective, multicenter study including patients with candidemia (Jan 2018–Dec 2022) from 3 hospitals in Italy and Spain. The primary outcome was persistent candidemia, defined as positive blood culture (BC) yielding the same Candida spp≥5 days from the start of active antifungals. Patients with no available follow-up BCs were excluded. A competing risk analysis (competing risk of death) was performed using Fine and Gray regression models.
Results |
Among 1188 patients, 298 (25.1%) had persistent candidemia. Cancer (sHR 1.335, 95% CI 1.037–1.633, p=0.011), total parenteral nutrition (sHR 1.440, 95%CI 1.062–1.818, p=0.006), Candida parapsilosis (sHR 1.312, 95% CI 1.075–1.633, p=0.03) and Candida auris (sHR 1.549, 95% CI 1.155–2.159, p=0.029) compared to Candida albicans, were associated with increased risk of persistent candidemia, whereas primary candidemia (sHR 0.573, 95% CI 0.321–0.825, p<0.001) and early source control (sHR 0.557, 95% CI 0.401–0.713, p<0.001) were protective. Persistent candidemia was associated with higher 30-day mortality (aHR 1.605, 95% CI 1.176–2.191, p=0.003).
Conclusions |
Persistent candidemia affects one in four patients with Candida BSI. Infections caused by Candida parapsilosis or Candida auris require individualized management, with early source control being essential to reduce the risk of persistence.
Le texte complet de cet article est disponible en PDF.Graphical Abstract |
Highlights |
• | Persistent candidemia occurred in 25.1% of patients despite antifungal therapy. |
• | C. auris and C. parapsilosis may cause persistent candidemia. |
• | Early source control was protective against persistent candidemia. |
• | Persistent candidemia was associated with increased 30-day mortality. |
Keywords : Candida, Candidemia, C. auris, C. parapsilosis, Persistent candidemia
Plan
Vol 91 - N° 3
Article 106586- septembre 2025 Retour au numéro
Article précédent
- Neutralizing GM-CSF autoantibodies impair neutrophil antifungal effector function in a patient with aspergillosis
- Andrew L. Wishart, Joseph Pechacek, Lindsey B. Rosen, Jigar V. Desai, Marissa A. Zarakas, Taura Webb, Stefania Pittaluga, Amir Seyedmousavi, Tobias M. Hohl, Douglas B. Kuhns, Steven M. Holland, Michail S. Lionakis
- Rad6 and Bre1 ubiquitin ligase negatively regulate biofilm formation and virulence in Candida glabrata
- Yi-Hang Lee, Li-Hang Hsu, Zi-Heng Yu, Kai-Quan Leong, Hao-Sen Chiang, Ying-Lien Chen
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?