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Multicenter Study
. 2024 Sep 27;28(1):320.
doi: 10.1186/s13054-024-05104-w.

Relationship between SARS-CoV-2 infection and ICU-acquired candidemia in critically ill medical patients: a multicenter prospective cohort study

Florian Reizine  1 , Nicolas Massart  2 , Alexandre Mansour  3 , Yannick Fedun  4 , Anaïs Machut  5 , Charles-Hervé Vacheron  5   6   7 , Anne Savey  5   7 , Arnaud Friggeri  5   6   7 , Alain Lepape  5   6   7 ; REAREZO study group
Collaborators, Affiliations
Multicenter Study

Relationship between SARS-CoV-2 infection and ICU-acquired candidemia in critically ill medical patients: a multicenter prospective cohort study

Florian Reizine et al. Crit Care. .

Abstract

Background: While SARS-CoV2 infection has been shown to be a significant risk-factor for several secondary bacterial, viral and Aspergillus infections, its impact on intensive care unit (ICU)-acquired candidemia (ICAC) remains poorly explored.

Method: Using the REA-REZO network (French surveillance network of ICU-acquired infections), we included all adult patients hospitalized for a medical reason of admission in participating ICUs for at least 48 h from January 2020 to January 2023. To account for confounders, a non-parsimonious propensity score matching was performed. Rates of ICAC according to SARS-CoV2 status were compared in matched patients. Factors associated with ICAC in COVID-19 patients were also assessed using a Fine-Gray model.

Results: A total of 55,268 patients hospitalized at least 48 h for a medical reason in 101 ICUs were included along the study period. Of those, 13,472 were tested positive for a SARS-CoV2 infection while 284 patients developed an ICAC. ICAC rate was higher in COVID-19 patients in both the overall population and the matched patients' cohort (0.8% (107/13,472) versus 0.4% (173/41,796); p < 0.001 and 0.8% (93/12,241) versus 0.5% (57/12,241); p = 0.004, respectively). ICAC incidence rate was also higher in those patients (incidence rate 0.51 per 1000 patients-days in COVID-19 patients versus 0.32 per 1000 patients-days; incidence rate ratio: 1.58 [95% CI:1.08-2.35]; p = 0.018). Finally, patients with ICAC had a higher ICU mortality rate (49.6% versus 20.2%; p < 0.001).

Conclusion: In this large multicenter cohort of ICU patients, although remaining low, the rate of ICAC was higher among COVID-19 patients.

Keywords: COVID-19; Candidaemia; Healthcare associated infection; ICU.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow Chart
Fig. 2
Fig. 2
Cumulative incidence of candidaemia in matched patients according to COVID-19 status
See this image and copyright information in PMC

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