Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 May 25;10(6):378.
doi: 10.3390/jof10060378.

Insights into Candida Colonization in Intensive Care Unit Patients: A Prospective Multicenter Study

Teresa Nascimento  1   2 , João Inácio  3 , Daniela Guerreiro  2 , Patrícia Patrício  4 , Luís Proença  2 , Cristina Toscano  5 , Priscila Diaz  6 , Helena Barroso  2
Affiliations

Insights into Candida Colonization in Intensive Care Unit Patients: A Prospective Multicenter Study

Teresa Nascimento et al. J Fungi (Basel). .

Abstract

The skin mycobiota plays a significant role in infection risk, pathogen transmission, and personalized medicine approaches in intensive care settings. This prospective multicenter study aimed to enhance our understanding of intensive care units' (ICUs') Candida colonization dynamics, identify modifiable risk factors, and assess their impact on survival risk. Specimens were taken from 675, 203, and 110 patients at the admission (D1), 5th (D5), and 8th (D8) days of ICU stay, respectively. The patient's demographic and clinical data were collected. Candida isolates were identified by conventional culture-based microbiology combined with molecular approaches. Overall, colonization was 184/675 (27.3%), 87/203 (42.8%), and 58/110 (52.7%) on D1, D5, and D8, respectively. Candida colonization dynamics were significantly associated with ICU type (odds ratio (OR) = 2.03, 95% CI 1.22-3.39, p = 0.007), respiratory infection (OR = 1.74, 95% CI 1.17-2.58, p = 0.006), hemodialysis (OR = 2.19, 95% CI 1.17-4.10, p = 0.014), COVID-19 (OR = 0.37, 95% CI 0.14-0.99, p = 0.048), and with a poor 3-month outcome (p = 0.008). Skin Candida spp. colonization can be an early warning tool to generate valuable insights into the epidemiology, risk factors, and survival rates of critically ill patients, and should be considered for epidemiological surveillance.

Keywords: Candida spp.; colonization; intensive care unit; prevalence; risk factors; surveillance.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Workflow of the identification procedures used with Candida spp. isolates [18,19].
Figure 2
Figure 2
Distribution of colonization density in the ICU: (a) overall; (b) on admission day (D1); day 5 (D5); and day 8 (D8).
Figure 3
Figure 3
Diversity of Candida spp. during the whole length of ICU stay (D1, D5, and D8).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Lamoth F., Lewis R.E., Kontoyiannis D.P. Role and Interpretation of Antifungal Susceptibility Testing for the Management of Invasive Fungal Infections. J. Fungi. 2020;7:17. doi: 10.3390/jof7010017. - DOI - PMC - PubMed
    1. Lamoth F. Novel Therapeutic Approaches to Invasive Candidiasis: Considerations for the Clinician. Infect. Drug Resist. 2023;16:1087–1097. doi: 10.2147/IDR.S375625. - DOI - PMC - PubMed
    1. Poissy J., Rouzé A., Cornu M., Nseir S., Sendid B. The Changing Landscape of Invasive Fungal Infections in ICUs: A Need for Risk Stratification to Better Target Antifungal Drugs and the Threat of Resistance. J. Fungi. 2022;8:946. doi: 10.3390/jof8090946. - DOI - PMC - PubMed
    1. Pappas P.G., Lionakis M.S., Arendrup M.C., Ostrosky-Zeichner L., Kullberg B.J. Invasive candidiasis. Nat. Rev. Dis. Primers. 2018;4:18026. doi: 10.1038/nrdp.2018.26. - DOI - PubMed
    1. Donnelly J.P., Chen S.C., Kauffman C.A., Steinbach W.J., Baddley J.W., Verweij P.E., Clancy C.J., Wingard J.R., Lockhart S.R., Groll A.H., et al. Revision and Update of the Consensus Definitions of Invasive Fungal Disease From the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium. Clin. Infect. Dis. 2020;71:1367–1376. doi: 10.1093/cid/ciz1008. - DOI - PMC - PubMed

LinkOut - more resources