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. 2022 Mar 16;8(3):305.
doi: 10.3390/jof8030305.

Incidence of Candidemia Is Higher in COVID-19 versus Non-COVID-19 Patients, but Not Driven by Intrahospital Transmission

Marina Machado  1   2 , Agustín Estévez  1   2 , Carlos Sánchez-Carrillo  1   2   3 , Jesús Guinea  1   2   3 , Pilar Escribano  1   2 , Roberto Alonso  1   2   3   4 , Maricela Valerio  1   2 , Belén Padilla  1   2 , Emilio Bouza  1   2   3   4 , Patricia Muñoz  1   2   3   4
Affiliations

Incidence of Candidemia Is Higher in COVID-19 versus Non-COVID-19 Patients, but Not Driven by Intrahospital Transmission

Marina Machado et al. J Fungi (Basel). .

Abstract

There is scarce information on the actual incidence of candidemia in COVID-19 patients. In addition, comparative studies of candidemia episodes in COVID-19 and non-COVID-19 patients are heterogeneous. Here, we assessed the real incidence, epidemiology, and etiology of candidemia in COVID-19 patients, and compared them with those without COVID-19 (2020 vs. 2019 and 2020, respectively). We also genotyped all C. albicans, C. parapsilosis, and C. tropicalis isolates (n = 88), causing candidemia in both groups, providing for the first time a genotypic characterization of isolates gathered in patients with either COVID-19 or non-COVID-19. Incidence of candidemia was higher in patients with COVID-19 than non-COVID-19 (4.73 vs. 0.85 per 1000 admissions; 3.22 vs. 1.14 per 10,000 days of stay). No substantial intergroup differences were found, including mortality. Genotyping proved the presence of a low number of patients involved in clusters, allowing us to rule out rampant patient-to-patient Candida transmission. The four patients, involved in two clusters, had catheter-related candidemia diagnosed in the first COVID-19 wave, which demonstrates breaches in catheter management policies occurring in such an overwhelming situation. In conclusion, the incidence of candidemia in patients with COVID-19 is significantly higher than in those without COVID-19. However, genotyping shows that this increase is not due to uncontrolled intrahospital transmission.

Keywords: COVID-19; candidemia; epidemiology; invasive candidiasis; invasive fungal infection; risk factors; viral–fungal coinfection.

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Conflict of interest statement

MM reports personal speaker fees from Gilead and Pfizer, outside the submitted work. PM reports personal fees from Pfizer and Gilead, outside the submitted work. JG has received funds for participating at educational activities organized on behalf of Gilead and Pfizer; he has also received research funds from FIS, Gilead, Scynexis, F2G, and Cidara, outside the submitted work. AE, CSC, PE, RA, MV, BP, EB declare no conflict of interest.

Figures

Figure 1
Figure 1
Minimum Spanning Tree showing the genetic relationship of C. albicans isolates. The source of the isolate is depicted in red (patients with COVID-19) or green (patients without COVID-19). Circles represent different genotypes, while partitions within the circles indicate the number of patients belonging to the same cluster. Connecting lines between the circles show profile similarities: solid bold, solid, dashed, and dotted lines indicate differences in one, two, three, or four markers, respectively. * Clusters involving patients with no epidemiological relationships are indicated by an asterisk.
See this image and copyright information in PMC

References

    1. Song G., Liang G., Liu W. Fungal Co-infections Associated with Global COVID-19 Pandemic: A Clinical and Diagnostic Perspective from China. Mycopathologia. 2020;185:599–606. doi: 10.1007/s11046-020-00462-9. - DOI - PMC - PubMed
    1. Rawson T.M., Moore L.S.P., Zhu N., Ranganathan N., Skolimowska K., Gilchrist M., Satta G., Cooke G., Holmes A. Bacterial and Fungal Coinfection in Individuals with Coronavirus: A Rapid Review to Support COVID-19 Antimicrobial Prescribing. Clin. Infect. Dis. 2020;71:2459–2468. doi: 10.1093/cid/ciaa530. - DOI - PMC - PubMed
    1. Nori P., Cowman K., Chen V., Bartash R., Szymczak W., Madaline T., Punjabi Katiyar C., Jain R., Aldrich M., Weston G., et al. Bacterial and fungal coinfections in COVID-19 patients hospitalized during the New York City pandemic surge. Infect. Control Hosp. Epidemiol. 2021;42:84–88. doi: 10.1017/ice.2020.368. - DOI - PMC - PubMed
    1. Garcia-Vidal C., Sanjuan G., Moreno-Garcia E., Puerta-Alcalde P., Garcia-Pouton N., Chumbita M., Fernandez-Pittol M., Pitart C., Inciarte A., Bodro M., et al. Incidence of co-infections and superinfections in hospitalized patients with COVID-19: A retrospective cohort study. Clin. Microbiol. Infect. 2021;27:83–88. doi: 10.1016/j.cmi.2020.07.041. - DOI - PMC - PubMed
    1. Bassetti M., Kollef M.H., Timsit J.F. Bacterial and fungal superinfections in critically ill patients with COVID-19. Intensive Care Med. 2020;46:2071–2074. doi: 10.1007/s00134-020-06219-8. - DOI - PMC - PubMed

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