Incidence and risk factors for COVID‐19 associated candidemia (CAC) in ICU patients

Abstract

Candidemia is one of the most common nosocomial bloodstream infections in critically ill patients, accounting for 7%-15% of the episodes, and is associated with increased mortality, prolonged hospital stays, and increased cost. 1,2 Non-neutropenic intensive care unit (ICU) patients undergoing multiple invasive procedures, and immunocompromised patients are at high risk for the development of candidemia. 3,4 The COVID-19 pandemic caused an increase in the number of patients who need to be followed up in ICU, creating a

Development and validation of COVID‐19 associated candidemia score (CAC‐Score) in ICU patients

“… 11 However, in all previous studies, multifocal candida colonisation rates in patients with candidemia were reported to be around 40–55%. 9 , 10 , 11 , 17 Therefore, there is a need to increase the predictive value on candidemia by evaluating risk factors together. Detection of multifocal colonisation is a useful predictor for candidemia, especially in patients with CVC.…”

“…This was a result we expected based on our previous study. 11 In Leon's Candida score study, the rate of corticosteroid use was similar in patients with unifocal/multifocal Candida spp. colonisation and those with proven candida infection (24.2% vs 22.7%), and corticosteroid use was not an independent risk factor for proven candida infection.…”

“…In our previous study, a prolonged ICU stay (≥14 days) had been also detected to be significantly associated with candidemia (OR 1.9, 95% CI 1.08–3–37, p < .05). 11 The duration of ICU/ward hospitalisation had not usually been included in candidemia score studies. In the clinical prediction rule study of Guillamet et al, investigating the presence of candidemia in 2597 sepsis and septic shock patients with positive blood culture, although the duration of hospitalisation prior to blood culture positivity was found to be longer in the candidemia group than in non‐candidemia group (those with bacteremia) in univariate analysis, it was not significantly associated with an increased risk of sepsis or septic shock with Candida spp.…”

“…In our previous study, we had investigated risk factors for the development of candidemia in COVID‐19 ICUs. 11 In this study, we planned to develop an easy‐to‐use prediction score for candidemia. Because we had recognised that the patients with candidemia could not be predicted in the early time of ICU follow‐up and almost 40% of these patients were died before antifungal treatment could be started.…”

Multiple Candida strains causing oral infection in COVID-19 patients under corticosteroids and antibiotic therapy: An observational study

“…Most of these patients have risk factors making them prone to fungal infections, such as hospitalization in the intensive care unit (ICU), high pres cription rates of broad-spectrum antibiotics, corticosteroid therapy, use of various catheters, underlying diseases, and immunodeficiencies. Among the opportunistic fungal infections, (e.g., Aspergillosis, Mucormycosis, and Candidiasis) the most common fungal co-infections during previous influenza pandemic outbreaks are now the most common fungal co-infections in COVID-19 patients (Meijer et al, 2020;Salehi et al, 2020;Fortarezza et al, 2021;Kayaaslan et al, 2021;Kayaaslan et al, 2022;Vaseghi et al, 2022).…”