Candidemia Among Coronavirus Disease 2019 Patients in Turkey Admitted to Intensive Care Units: A Retrospective Multicenter Study

Abstract Background We evaluated the epidemiology of candidemia among coronavirus disease 2019 (COVID-19) patients admitted to intensive care units (ICUs). Methods We conducted a retrospective multicenter study in Turkey between April and December 2020. Results Twenty-eight of 148 enrolled patients...

Full description

Saved in:
Bibliographic Details
Published in:Open forum infectious diseases 2022-04, Vol.9 (4), p.ofac078
Main Authors: Arastehfar, Amir, Ünal, Nevzat, Hoşbul, Tuğrul, Alper Özarslan, Muhammed, Sultan Karakoyun, Ayşe, Polat, Furkan, Fuentes, Diego, Gümral, Ramazan, Turunç, Tuba, Daneshnia, Farnaz, Perlin, David S, Lass-Flörl, Cornelia, Gabaldón, Toni, Ilkit, Macit, Nguyen, M Hong
Format: Article
Language:English
Subjects:
Major
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c483t-d477af6d68a1065f6a6bf9456427c8fcff8badcb648edd037e467b9d96f846583
cites cdi_FETCH-LOGICAL-c483t-d477af6d68a1065f6a6bf9456427c8fcff8badcb648edd037e467b9d96f846583
container_end_page
container_issue 4
container_start_page ofac078
container_title Open forum infectious diseases
container_volume 9
creator Arastehfar, Amir
Ünal, Nevzat
Hoşbul, Tuğrul
Alper Özarslan, Muhammed
Sultan Karakoyun, Ayşe
Polat, Furkan
Fuentes, Diego
Gümral, Ramazan
Turunç, Tuba
Daneshnia, Farnaz
Perlin, David S
Lass-Flörl, Cornelia
Gabaldón, Toni
Ilkit, Macit
Nguyen, M Hong
description Abstract Background We evaluated the epidemiology of candidemia among coronavirus disease 2019 (COVID-19) patients admitted to intensive care units (ICUs). Methods We conducted a retrospective multicenter study in Turkey between April and December 2020. Results Twenty-eight of 148 enrolled patients developed candidemia, yielding an incidence of 19% and incidence rate of 14/1000 patient-days. The probability of acquiring candidemia at 10, 20, and 30 days of ICU admission was 6%, 26%, and 50%, respectively. More than 80% of patients received antibiotics, corticosteroid, and mechanical ventilation. Receipt of a carbapenem (odds ratio [OR] = 6.0, 95% confidence interval [CI] = 1.6–22.3, P = .008), central venous catheter (OR = 4.3, 95% CI = 1.3–14.2, P = .02), and bacteremia preceding candidemia (OR = 6.6, 95% CI = 2.1–20.1, P = .001) were independent risk factors for candidemia. The mortality rate did not differ between patients with and without candidemia. Age (OR = 1.05, 95% CI = 1.01–1.09, P = .02) and mechanical ventilation (OR = 61, 95% CI = 15.8–234.9, P 
doi_str_mv 10.1093/ofid/ofac078
format article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8903397</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/ofid/ofac078</oup_id><sourcerecordid>2644951190</sourcerecordid><originalsourceid>FETCH-LOGICAL-c483t-d477af6d68a1065f6a6bf9456427c8fcff8badcb648edd037e467b9d96f846583</originalsourceid><addsrcrecordid>eNp9kcFvFCEUh4nR2GbtzbPhpge3wsAw4MFkM2pt0kaj7Zkww6OiM7AFZpO9-ad3Nrs27aUXHsn78r338kPoNSWnlCj2ITpv58f0pJHP0HHFKrmUqm6eP_gfoZOc_xBCKCU1adRLdMRqxmsh6mP0rzXBegujN3g1xnCD25hiMBufpow_-wwmA64IVfiHKR5CydgHfDWlv7DFKzv6UsDiEvF5KBCy3wBuTQJ8HXzJH_EK_4SSYl5DX3a9y2kovp81kPCvMtntK_TCmSHDyaEu0PXXL1ftt-XF97PzdnWx7LlkZWl50xgnrJCGElE7YUTn1HwEr5peut452Rnbd4JLsJawBrhoOmWVcJKLWrIF-rT3rqduBLtbIZlBr5MfTdrqaLx-3An-t76JGy0VYUw1s-DdQZDi7QS56NHnHobBBIhT1pXgXNWUzvgCvd-j_Xx5TuDux1Cid7npXW76kNuMv3m42j38P6UZeLsH4rR-WnUH0YWlPA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2644951190</pqid></control><display><type>article</type><title>Candidemia Among Coronavirus Disease 2019 Patients in Turkey Admitted to Intensive Care Units: A Retrospective Multicenter Study</title><source>PubMed Central Free</source><source>Oxford Academic Journals (Open Access)</source><creator>Arastehfar, Amir ; Ünal, Nevzat ; Hoşbul, Tuğrul ; Alper Özarslan, Muhammed ; Sultan Karakoyun, Ayşe ; Polat, Furkan ; Fuentes, Diego ; Gümral, Ramazan ; Turunç, Tuba ; Daneshnia, Farnaz ; Perlin, David S ; Lass-Flörl, Cornelia ; Gabaldón, Toni ; Ilkit, Macit ; Nguyen, M Hong</creator><creatorcontrib>Arastehfar, Amir ; Ünal, Nevzat ; Hoşbul, Tuğrul ; Alper Özarslan, Muhammed ; Sultan Karakoyun, Ayşe ; Polat, Furkan ; Fuentes, Diego ; Gümral, Ramazan ; Turunç, Tuba ; Daneshnia, Farnaz ; Perlin, David S ; Lass-Flörl, Cornelia ; Gabaldón, Toni ; Ilkit, Macit ; Nguyen, M Hong</creatorcontrib><description>Abstract Background We evaluated the epidemiology of candidemia among coronavirus disease 2019 (COVID-19) patients admitted to intensive care units (ICUs). Methods We conducted a retrospective multicenter study in Turkey between April and December 2020. Results Twenty-eight of 148 enrolled patients developed candidemia, yielding an incidence of 19% and incidence rate of 14/1000 patient-days. The probability of acquiring candidemia at 10, 20, and 30 days of ICU admission was 6%, 26%, and 50%, respectively. More than 80% of patients received antibiotics, corticosteroid, and mechanical ventilation. Receipt of a carbapenem (odds ratio [OR] = 6.0, 95% confidence interval [CI] = 1.6–22.3, P = .008), central venous catheter (OR = 4.3, 95% CI = 1.3–14.2, P = .02), and bacteremia preceding candidemia (OR = 6.6, 95% CI = 2.1–20.1, P = .001) were independent risk factors for candidemia. The mortality rate did not differ between patients with and without candidemia. Age (OR = 1.05, 95% CI = 1.01–1.09, P = .02) and mechanical ventilation (OR = 61, 95% CI = 15.8–234.9, P &lt; .0001) were independent risk factors for death. Candida albicans was the most prevalent species overall. In Izmir, Candida parapsilosis accounted for 50% (2 of 4) of candidemia. Both C parapsilosis isolates were fluconazole nonsusceptible, harbored Erg11-Y132F mutation, and were clonal based on whole-genome sequencing. The 2 infected patients resided in ICUs with ongoing outbreaks due to fluconazole-resistant C parapsilosis. Conclusions Physicians should be aware of the elevated risk for candidemia among patients with COVID-19 who require ICU care. Prolonged ICU exposure and ICU practices rendered to COVID-19 patients are important contributing factors to candidemia. Emphasis should be placed on (1) heightened infection control in the ICU and (2) developing antibiotic stewardship strategies to reduce irrational antimicrobial therapy. Critically ill patients with COVID-19 in the intensive care units (ICU) are at elevated risk for candidemia. Prolonged ICU and COVID-19 management are important contributing factors. Improved infection control and antibiotic stewardship practices to curb irrational antimicrobial utilization are needed.</description><identifier>ISSN: 2328-8957</identifier><identifier>EISSN: 2328-8957</identifier><identifier>DOI: 10.1093/ofid/ofac078</identifier><identifier>PMID: 35345665</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Major</subject><ispartof>Open forum infectious diseases, 2022-04, Vol.9 (4), p.ofac078</ispartof><rights>The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. 2022</rights><rights>The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c483t-d477af6d68a1065f6a6bf9456427c8fcff8badcb648edd037e467b9d96f846583</citedby><cites>FETCH-LOGICAL-c483t-d477af6d68a1065f6a6bf9456427c8fcff8badcb648edd037e467b9d96f846583</cites><orcidid>0000-0002-1174-4182 ; 0000-0002-9977-6786</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8903397/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8903397/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,1604,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35345665$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Arastehfar, Amir</creatorcontrib><creatorcontrib>Ünal, Nevzat</creatorcontrib><creatorcontrib>Hoşbul, Tuğrul</creatorcontrib><creatorcontrib>Alper Özarslan, Muhammed</creatorcontrib><creatorcontrib>Sultan Karakoyun, Ayşe</creatorcontrib><creatorcontrib>Polat, Furkan</creatorcontrib><creatorcontrib>Fuentes, Diego</creatorcontrib><creatorcontrib>Gümral, Ramazan</creatorcontrib><creatorcontrib>Turunç, Tuba</creatorcontrib><creatorcontrib>Daneshnia, Farnaz</creatorcontrib><creatorcontrib>Perlin, David S</creatorcontrib><creatorcontrib>Lass-Flörl, Cornelia</creatorcontrib><creatorcontrib>Gabaldón, Toni</creatorcontrib><creatorcontrib>Ilkit, Macit</creatorcontrib><creatorcontrib>Nguyen, M Hong</creatorcontrib><title>Candidemia Among Coronavirus Disease 2019 Patients in Turkey Admitted to Intensive Care Units: A Retrospective Multicenter Study</title><title>Open forum infectious diseases</title><addtitle>Open Forum Infect Dis</addtitle><description>Abstract Background We evaluated the epidemiology of candidemia among coronavirus disease 2019 (COVID-19) patients admitted to intensive care units (ICUs). Methods We conducted a retrospective multicenter study in Turkey between April and December 2020. Results Twenty-eight of 148 enrolled patients developed candidemia, yielding an incidence of 19% and incidence rate of 14/1000 patient-days. The probability of acquiring candidemia at 10, 20, and 30 days of ICU admission was 6%, 26%, and 50%, respectively. More than 80% of patients received antibiotics, corticosteroid, and mechanical ventilation. Receipt of a carbapenem (odds ratio [OR] = 6.0, 95% confidence interval [CI] = 1.6–22.3, P = .008), central venous catheter (OR = 4.3, 95% CI = 1.3–14.2, P = .02), and bacteremia preceding candidemia (OR = 6.6, 95% CI = 2.1–20.1, P = .001) were independent risk factors for candidemia. The mortality rate did not differ between patients with and without candidemia. Age (OR = 1.05, 95% CI = 1.01–1.09, P = .02) and mechanical ventilation (OR = 61, 95% CI = 15.8–234.9, P &lt; .0001) were independent risk factors for death. Candida albicans was the most prevalent species overall. In Izmir, Candida parapsilosis accounted for 50% (2 of 4) of candidemia. Both C parapsilosis isolates were fluconazole nonsusceptible, harbored Erg11-Y132F mutation, and were clonal based on whole-genome sequencing. The 2 infected patients resided in ICUs with ongoing outbreaks due to fluconazole-resistant C parapsilosis. Conclusions Physicians should be aware of the elevated risk for candidemia among patients with COVID-19 who require ICU care. Prolonged ICU exposure and ICU practices rendered to COVID-19 patients are important contributing factors to candidemia. Emphasis should be placed on (1) heightened infection control in the ICU and (2) developing antibiotic stewardship strategies to reduce irrational antimicrobial therapy. Critically ill patients with COVID-19 in the intensive care units (ICU) are at elevated risk for candidemia. Prolonged ICU and COVID-19 management are important contributing factors. Improved infection control and antibiotic stewardship practices to curb irrational antimicrobial utilization are needed.</description><subject>Major</subject><issn>2328-8957</issn><issn>2328-8957</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>TOX</sourceid><recordid>eNp9kcFvFCEUh4nR2GbtzbPhpge3wsAw4MFkM2pt0kaj7Zkww6OiM7AFZpO9-ad3Nrs27aUXHsn78r338kPoNSWnlCj2ITpv58f0pJHP0HHFKrmUqm6eP_gfoZOc_xBCKCU1adRLdMRqxmsh6mP0rzXBegujN3g1xnCD25hiMBufpow_-wwmA64IVfiHKR5CydgHfDWlv7DFKzv6UsDiEvF5KBCy3wBuTQJ8HXzJH_EK_4SSYl5DX3a9y2kovp81kPCvMtntK_TCmSHDyaEu0PXXL1ftt-XF97PzdnWx7LlkZWl50xgnrJCGElE7YUTn1HwEr5peut452Rnbd4JLsJawBrhoOmWVcJKLWrIF-rT3rqduBLtbIZlBr5MfTdrqaLx-3An-t76JGy0VYUw1s-DdQZDi7QS56NHnHobBBIhT1pXgXNWUzvgCvd-j_Xx5TuDux1Cid7npXW76kNuMv3m42j38P6UZeLsH4rR-WnUH0YWlPA</recordid><startdate>20220401</startdate><enddate>20220401</enddate><creator>Arastehfar, Amir</creator><creator>Ünal, Nevzat</creator><creator>Hoşbul, Tuğrul</creator><creator>Alper Özarslan, Muhammed</creator><creator>Sultan Karakoyun, Ayşe</creator><creator>Polat, Furkan</creator><creator>Fuentes, Diego</creator><creator>Gümral, Ramazan</creator><creator>Turunç, Tuba</creator><creator>Daneshnia, Farnaz</creator><creator>Perlin, David S</creator><creator>Lass-Flörl, Cornelia</creator><creator>Gabaldón, Toni</creator><creator>Ilkit, Macit</creator><creator>Nguyen, M Hong</creator><general>Oxford University Press</general><scope>TOX</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-1174-4182</orcidid><orcidid>https://orcid.org/0000-0002-9977-6786</orcidid></search><sort><creationdate>20220401</creationdate><title>Candidemia Among Coronavirus Disease 2019 Patients in Turkey Admitted to Intensive Care Units: A Retrospective Multicenter Study</title><author>Arastehfar, Amir ; Ünal, Nevzat ; Hoşbul, Tuğrul ; Alper Özarslan, Muhammed ; Sultan Karakoyun, Ayşe ; Polat, Furkan ; Fuentes, Diego ; Gümral, Ramazan ; Turunç, Tuba ; Daneshnia, Farnaz ; Perlin, David S ; Lass-Flörl, Cornelia ; Gabaldón, Toni ; Ilkit, Macit ; Nguyen, M Hong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c483t-d477af6d68a1065f6a6bf9456427c8fcff8badcb648edd037e467b9d96f846583</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Major</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Arastehfar, Amir</creatorcontrib><creatorcontrib>Ünal, Nevzat</creatorcontrib><creatorcontrib>Hoşbul, Tuğrul</creatorcontrib><creatorcontrib>Alper Özarslan, Muhammed</creatorcontrib><creatorcontrib>Sultan Karakoyun, Ayşe</creatorcontrib><creatorcontrib>Polat, Furkan</creatorcontrib><creatorcontrib>Fuentes, Diego</creatorcontrib><creatorcontrib>Gümral, Ramazan</creatorcontrib><creatorcontrib>Turunç, Tuba</creatorcontrib><creatorcontrib>Daneshnia, Farnaz</creatorcontrib><creatorcontrib>Perlin, David S</creatorcontrib><creatorcontrib>Lass-Flörl, Cornelia</creatorcontrib><creatorcontrib>Gabaldón, Toni</creatorcontrib><creatorcontrib>Ilkit, Macit</creatorcontrib><creatorcontrib>Nguyen, M Hong</creatorcontrib><collection>Oxford Academic Journals (Open Access)</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Open forum infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Arastehfar, Amir</au><au>Ünal, Nevzat</au><au>Hoşbul, Tuğrul</au><au>Alper Özarslan, Muhammed</au><au>Sultan Karakoyun, Ayşe</au><au>Polat, Furkan</au><au>Fuentes, Diego</au><au>Gümral, Ramazan</au><au>Turunç, Tuba</au><au>Daneshnia, Farnaz</au><au>Perlin, David S</au><au>Lass-Flörl, Cornelia</au><au>Gabaldón, Toni</au><au>Ilkit, Macit</au><au>Nguyen, M Hong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Candidemia Among Coronavirus Disease 2019 Patients in Turkey Admitted to Intensive Care Units: A Retrospective Multicenter Study</atitle><jtitle>Open forum infectious diseases</jtitle><addtitle>Open Forum Infect Dis</addtitle><date>2022-04-01</date><risdate>2022</risdate><volume>9</volume><issue>4</issue><spage>ofac078</spage><pages>ofac078-</pages><issn>2328-8957</issn><eissn>2328-8957</eissn><abstract>Abstract Background We evaluated the epidemiology of candidemia among coronavirus disease 2019 (COVID-19) patients admitted to intensive care units (ICUs). Methods We conducted a retrospective multicenter study in Turkey between April and December 2020. Results Twenty-eight of 148 enrolled patients developed candidemia, yielding an incidence of 19% and incidence rate of 14/1000 patient-days. The probability of acquiring candidemia at 10, 20, and 30 days of ICU admission was 6%, 26%, and 50%, respectively. More than 80% of patients received antibiotics, corticosteroid, and mechanical ventilation. Receipt of a carbapenem (odds ratio [OR] = 6.0, 95% confidence interval [CI] = 1.6–22.3, P = .008), central venous catheter (OR = 4.3, 95% CI = 1.3–14.2, P = .02), and bacteremia preceding candidemia (OR = 6.6, 95% CI = 2.1–20.1, P = .001) were independent risk factors for candidemia. The mortality rate did not differ between patients with and without candidemia. Age (OR = 1.05, 95% CI = 1.01–1.09, P = .02) and mechanical ventilation (OR = 61, 95% CI = 15.8–234.9, P &lt; .0001) were independent risk factors for death. Candida albicans was the most prevalent species overall. In Izmir, Candida parapsilosis accounted for 50% (2 of 4) of candidemia. Both C parapsilosis isolates were fluconazole nonsusceptible, harbored Erg11-Y132F mutation, and were clonal based on whole-genome sequencing. The 2 infected patients resided in ICUs with ongoing outbreaks due to fluconazole-resistant C parapsilosis. Conclusions Physicians should be aware of the elevated risk for candidemia among patients with COVID-19 who require ICU care. Prolonged ICU exposure and ICU practices rendered to COVID-19 patients are important contributing factors to candidemia. Emphasis should be placed on (1) heightened infection control in the ICU and (2) developing antibiotic stewardship strategies to reduce irrational antimicrobial therapy. Critically ill patients with COVID-19 in the intensive care units (ICU) are at elevated risk for candidemia. Prolonged ICU and COVID-19 management are important contributing factors. Improved infection control and antibiotic stewardship practices to curb irrational antimicrobial utilization are needed.</abstract><cop>US</cop><pub>Oxford University Press</pub><pmid>35345665</pmid><doi>10.1093/ofid/ofac078</doi><orcidid>https://orcid.org/0000-0002-1174-4182</orcidid><orcidid>https://orcid.org/0000-0002-9977-6786</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 2328-8957
ispartof Open forum infectious diseases, 2022-04, Vol.9 (4), p.ofac078
issn 2328-8957
2328-8957
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8903397
source PubMed Central Free; Oxford Academic Journals (Open Access)
subjects Major
title Candidemia Among Coronavirus Disease 2019 Patients in Turkey Admitted to Intensive Care Units: A Retrospective Multicenter Study
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-04T12%3A19%3A43IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Candidemia%20Among%20Coronavirus%20Disease%202019%20Patients%20in%20Turkey%20Admitted%20to%20Intensive%20Care%20Units:%20A%20Retrospective%20Multicenter%20Study&rft.jtitle=Open%20forum%20infectious%20diseases&rft.au=Arastehfar,%20Amir&rft.date=2022-04-01&rft.volume=9&rft.issue=4&rft.spage=ofac078&rft.pages=ofac078-&rft.issn=2328-8957&rft.eissn=2328-8957&rft_id=info:doi/10.1093/ofid/ofac078&rft_dat=%3Cproquest_pubme%3E2644951190%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c483t-d477af6d68a1065f6a6bf9456427c8fcff8badcb648edd037e467b9d96f846583%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2644951190&rft_id=info:pmid/35345665&rft_oup_id=10.1093/ofid/ofac078&rfr_iscdi=true