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. 2021 Feb;64(2):152-156.
doi: 10.1111/myc.13225. Epub 2020 Dec 10.

Increased incidence of candidemia in a tertiary care hospital with the COVID-19 pandemic

Marcio Nucci  1 , Gloria Barreiros  1 , Luiz Felipe Guimarães  1 , Vitor A S Deriquehem  1 , Anna Carla Castiñeiras  1 , Simone A Nouér  1
Affiliations

Increased incidence of candidemia in a tertiary care hospital with the COVID-19 pandemic

Marcio Nucci et al. Mycoses. 2021 Feb.

Abstract

Background: The incidence of candidemia in our hospital has been stable over an 18-year period (1.3 episodes per 1000 admissions). Since March 2020, we have observed an increase in cases of candidemia.

Methods: In March 2020, the hospital was prepared to receive patients with COVID-19, with cancellation of elective procedures, discharge of less sick patients and the activation of beds for COVID-19. We compared the incidence of candidemia in 2 periods: from January 2019 to February 2020 (period 1) and from March to September 2020 (period 2).

Results: We diagnosed 41 episodes of candidemia, 16 in period 1 and 25 in period 2 (9 COVID-19 patients). Compared with non-COVID-19 patients, COVID-19 patients with candidemia were more likely to be under mechanical ventilation (100% vs. 34.4%, P < .001). The median number of monthly admissions in period 1 and 2 was 723 (interquartile range 655-836) and 523 (interquartile range 389-574), respectively. The incidence of candidemia (per 1000 admissions) was 1.54 in period 1 and 7.44 in period 2 (P < .001). In period 2, the incidence of candidemia (per 1000 admissions) was 4.76 if we consider only cases of candidemia in non-COVID-19 patients, 2.68 if we consider only cases of candidemia in COVID-19 patients and 14.80 considering only admissions of patients with COVID-19.

Conclusions: The increase in the incidence of candidemia in our hospital may be attributed to 2 factors: a reduction in the number of admissions (denominator) and the occurrence of candidemia in COVID-19 patients.

Keywords: Candida; candidemia; deep fungal infection; epidemiology; systemic infection.

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Conflict of interest statement

Dr Nucci reports personal fees from Pfizer, personal fees from MSD, personal fees from Basilea, personal fees from Biotoscana, personal fees from Astellas, personal fees from Abbvie, personal fees from Amgen, personal fees from Janssen, outside the submitted work; Other authors: nothing to disclose.

Figures

FIGURE 1
FIGURE 1
Admissions and cases of candidemia in the 21‐month study period
See this image and copyright information in PMC

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