Vahibe Aydın SARIKAYA, Deniz TURAN, Sebahat AKSARAY, Recep BALIK, Seniha ŞENBAYRAK, Asuman İNAN, Serpil EROL, Nurgül CERAN
İstanbul Medical Journal - 2026;27(3):275-279
Introduction: Candidemia is a serious infection with high morbidity and mortality. This study evaluated the distribution of Candida species, antifungal susceptibility outcomes, and variables associated with mortality in cases of candidemia. Methods: Patients aged >=18 years with candidemia diagnosed between 2024 and 2025 were retrospectively analyzed. Associations between clinical variables and 30-day mortality were examined using logistic regression analyses, including both univariable and multivariable models. Results: The mean age of the 132 patients who developed candidemia was 68.7+/-15.4 years, and 46.2% were female. The dominant strain was Candida albicans, followed in order of frequency by C. glabrata and C. auris. The 30-day mortality rate was 55.3%. The highest mortality rate was observed in C. auris isolates (72.4%). In univariable analysis, intensive care unit (ICU) stay [odds ratio (OR): 17.26, 95% confidence interval (CI): 6.08-49.01; p<0.001], fluconazole resistance (OR: 2.92, 95% confidence interval (CI): 1.42-6.01; p=0.005), and amphotericin B resistance (OR: 3.57, 95% confidence interval (CI): 1.33-9.55; p=0.009) were significantly associated with mortality. All Candida albicans isolates were susceptible to fluconazole and echinocandins. All C. auris isolates were susceptible to echinocandins, while high rates of resistance to fluconazole (82.8%) and amphotericin B (89.7%) were observed. Evaluation of time to blood culture positivity showed that growth was detected in more than 90% of patients within the first two days. Conclusion: Candidemia is associated with a high mortality rate. ICU stay emerged as an independent predictor of 30-day mortality, while resistance to fluconazole and amphotericin B may also be associated with mortality. The identification of Candida auris as the third most common pathogen, along with its high resistance rates to fluconazole and amphotericin B, is particularly noteworthy. The finding that all isolates, including C. auris, were susceptible to echinocandins supports an echinocandin-based empirical treatment approach in patients with suspected candidemia.
