Candidemia is a major global health challenge, with Candida albicans being the most common cause. Since antifungal drugs may promote antifungal resistance, regular epidemiological studies are required. Nonetheless, microbiological and clinical data on C. albicans Türkiye is lacking. Therefore, we assessed data from C. albicans cases in a tertiary care hospital in Türkiye. Among 171 enrolled patients, the overall mortality rate was 66.7%. Univariate analysis showed that age, intensive care unit (ICU) admission, central venous catheter, mechanical ventilation, presence of hemodialysis, diabetes mellitus, COVID-19 infection, steroid use, and hyperalimentation were associated with mortality. Multivariate logistic regression showed that age, ICU admission, steroid use and hyperalimentation were independently associated with mortality. In the Cox regression, age, ICU admission, prior antifungal use, and no antifungal use after candidemia were independently associated with decreased survival. Fluconazole (FLC) was the most used antifungal, and patients treated with FLC+amphotericin B or FLC+echinocandin had the best survival rates. All 171 isolates were susceptible to all tested antifungals. The strains were all wild-type, showing no acquisition of antifungal resistance. Our findings show high mortality rates and reveal mortality-associated factors. Candida albicans remains susceptible to all antifungals. Therefore, timely diagnosis and antifungal treatment can enhance survival and clinical success.
Ünal et al. (Wed,) studied this question.
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