30-day mortality in invasive candidiasis and candidemia in a multidisciplinary hospital in Moscow

Articles in Press

Document Type : Original Articles

Authors

1 Clinical City Hospital 52 Ministry of Healthcare of Moscow, Russia

2 Clinical City Hospital 52 Ministry of Healthcare of Moscow, Russia First Sechenov Moscow State Medical University (Sechenov University), Moscow, Russia

3 Clinical City Hospital 52 Ministry of Healthcare of Moscow, Russia Russian Medical Academy of Continuous Professional Education, Moscow, Russia

4 Clinical City Hospital 52 Ministry of Healthcare of Moscow, Russia Pirogov Russian National Research Medical University, Moscow, Russia

10.22034/cmm.2025.345316.1590

Abstract

Background and Purpose: One of the most severe mycotic infections caused by Candida spp. is invasive candidiasis. According to the literature, among all healthcare-associated infections, it has the highest mortality rate. The purpose of the study was to assess 30-day and overall mortality in invasive candidiasis and candidemia patients depending on the antifungal therapy regimens.
Materials and Methods: A single-center retrospective study of 30-day survival was conducted at the 52 City clinic hospital Moscow healthcare department in 169 patients aged 19 to 94 years who had verified invasive candidiasis with candidemia during hospitalization in 2020–2023. The study included patients with Candida spp. isolated from blood culture using matrix-assisted laser desorption/ionization with time-of-flight mass spectrometry (MALDI-TOF MS, Bruker), and proven invasive candidiasis according to EORTC/MSG criteria. Patient survival analysis was performed using the Kaplan-Meier method, which is a nonparametric approach for estimating time-to-event. The risk of death was compared between the group of patients receiving antifungal therapy after pathogen verification and the group of patients receiving antifungal therapy before and after blood culture results.
Results: When analyzing 30-day mortality in patients with invasive candidiasis, the likelihood of death was lower in the group of patients who received antifungal therapy both after and before blood culture results compared to the group of patients in whom antifungal therapy was prescribed after verification of the diagnosis. By day 50 of hospitalization, the risks of death were comparable between groups. However, when analyzing overall mortality, the odds of death in patients with antifungal therapy before and after receiving blood culture results were 2.56 times higher (OR = 0.391; 95% CI: 0.177–0.865; p = 0.019) compared with patients to whom antifungal therapy was prescribed only after blood culture results.
Conclusion: Our study, assessing 30-day mortality and risk factors for death, provided the first data: the risk of 30-day mortality was lower in the group of patients receiving antifungal therapy both before and after blood culture, but overall mortality in this group was higher in compared with patients in whom antifungal therapy was initiated after the blood culture. 
 
 

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Current Medical Mycology

Articles in Press, Accepted Manuscript
Available Online from 09 March 2025

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History

  • Receive Date: 06 November 2024
  • Revise Date: 17 February 2025
  • Accept Date: 09 March 2025
  • Publish Date: 09 March 2025

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