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Background <p>Candidemia is a life-threatening invasive fungal infection, particularly in patients admitted to intensive care units (ICUs). Epidemiology of candidemia and antifungal resistance have been significantly affected in COVID-19 pandemic.</p> Methods <p>We analysed candidemia cases in neonatal, paediatric, and adult ICUs at Hippokration General Hospital in Thessaloniki, Greece (site 1) and Kayseri City Training and Research Hospital in Kayseri, Türkiye (site 2) from January 2020 to December 2023. Epidemiology, species distribution, and antifungal susceptibility of cases were compared.</p> Results <p>A total of 388 patients from site 1 and 379 patients from site 2 were included. A significant increase in the incidence of candidemia was observed in both hospitals during the COVID-19 pandemic. <i>Candida parapsilosis</i> was the most common species in all ICUs at Site 1, while <i>Candida albicans</i> was predominant at Site 2. <i>C. parapsilosis</i> became the most frequent species at Site 2 after 2021. <i>C. glabrata</i> was isolated more frequently in Site 1, whereas <i>C. tropicalis</i> was more frequently isolated in Site 2. A total of 14 <i>C. auris</i> strains were isolated, 13 of which were at the site 1. Over 90% of <i>C. albicans</i> strains were fluconazole-sensitive, but resistance was high in <i>C. parapsilosis</i> strains (47% at the site 1 and 40% at the site 2).</p> Conclusion <p><i>C. parapsilosis</i> and <i>C. albicans</i> remained the most common species, but their distributions varied between the two locations and over time. The high fluconazole resistance in <i>C. parapsilosis</i> causes a significant challenge for treatment. These findings highlight the necessity of continuous epidemiological surveillance to ensure appropriate antifungal treatment in different geographical regions.</p>

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Candidemia Epidemiology and Antifungal Resistance in Critically-ill Patients During and After COVID-19 Pandemic: Comparison Between Two Hospitals in Greece and Türkiye

  • 期刊论文

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  • 发表日期：

    2026年6月16日

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  • Esma Eryılmaz Eren,
  • Elias Iosifidis,
  • Hafize Sav,
  • Ilhami Celik,
  • Eleni Mouloudi,
  • Athina Pyrpasopoulou,
  • Charalampos Zarras,
  • Emmanuel Roilides

摘要

Background

Candidemia is a life-threatening invasive fungal infection, particularly in patients admitted to intensive care units (ICUs). Epidemiology of candidemia and antifungal resistance have been significantly affected in COVID-19 pandemic.

Methods

We analysed candidemia cases in neonatal, paediatric, and adult ICUs at Hippokration General Hospital in Thessaloniki, Greece (site 1) and Kayseri City Training and Research Hospital in Kayseri, Türkiye (site 2) from January 2020 to December 2023. Epidemiology, species distribution, and antifungal susceptibility of cases were compared.

Results

A total of 388 patients from site 1 and 379 patients from site 2 were included. A significant increase in the incidence of candidemia was observed in both hospitals during the COVID-19 pandemic. Candida parapsilosis was the most common species in all ICUs at Site 1, while Candida albicans was predominant at Site 2. C. parapsilosis became the most frequent species at Site 2 after 2021. C. glabrata was isolated more frequently in Site 1, whereas C. tropicalis was more frequently isolated in Site 2. A total of 14 C. auris strains were isolated, 13 of which were at the site 1. Over 90% of C. albicans strains were fluconazole-sensitive, but resistance was high in C. parapsilosis strains (47% at the site 1 and 40% at the site 2).

Conclusion

C. parapsilosis and C. albicans remained the most common species, but their distributions varied between the two locations and over time. The high fluconazole resistance in C. parapsilosis causes a significant challenge for treatment. These findings highlight the necessity of continuous epidemiological surveillance to ensure appropriate antifungal treatment in different geographical regions.