Clinical characteristics, management and outcomes of nonintensive care unit Candidemia: Subanalysis of the ECMM Candida III Multinational European Observational Cohort Study

Wolfgruber, Stella, Garcia-Vidal, Carolina, Sedik, Sarah, Salmanton-García, Jon, Arikan-Akdagli, Sevtap, Gangneux, Jean-Pierre, Rautemaa-Richardson, Riina, Arsic-Arsenijevic, Valentina, Martín-Pérez, Sonia, Dávila-Valls, Julio, Erben, Nurettin, Akalin, Emin Halis, Drgona, Lubos, Lass-Flörl, Cornelia, García-Rodríguez, Julio, Bicanic, Tihana, Hammarström, Helena, Hamal, Petr, Steinmann, Jörg, Meijer, Eelco F J, Khanna, Nina, Desoubeaux, Guillaume, Longval, Thomas, Sili, Uluhan, Trauth, Janina, Bassetti, Matteo, White, P. Lewis, Aujayeb, Avinash, Matos, Tadeja, Akyol, Deniz, Danion, Francois, Lagrou, Katrien, Rogers, Benedict, Ruiz, Maite, Siváková, Alena, Mikulska, Malgorzata, Samarkos, Michael, Blennow, Ola, Lockhart, Deborah E A, Denis, Blandine, Willinger, Birgit, van Dijk, Karin, Scharmann, Ulrike, Goodman, Anna L, van Praet, Jens, Narayanan, Manjusha, Toscano, Cristina, Loughlin, Laura, de Jonge, Nick Alexander, Ruiz-Gaitan, Alba, Lanternier, Fanny, Prattes, Juergen, Roilides, Emmanuel, Talento, Alida Fe, Barac, Aleksandra, Egger, Matthias, Arendrup, Maiken Cavling, Koehler, Philipp, Cornely, Oliver A, Hoenigl, Martin, Akova, Murat, Zurl, Christoph, Stoma, Igor, Calbacho, Maria, Azap, Alpay, Kessel, Johanna, Racil, Zdenek, Taramasso, Lucia, Peri, Anna Maria, Jereb, Matja?, Turhan, Ozge, Klimko, Nikolai and Tumbarello, Mario 2026. Clinical characteristics, management and outcomes of nonintensive care unit Candidemia: Subanalysis of the ECMM Candida III Multinational European Observational Cohort Study. Open Forum Infectious Diseases 13 (4) 10.1093/ofid/ofag133

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Abstract

The European Confederation of Medical Mycology Candida III was a pan-European, multicenter observational study of adult patients with blood culture–proven candidemia. Among a total of 632 patients with candidemia across 64 institutions in 20 European countries, a subanalysis of 396 (63%) cases occurring outside the intensive care unit (ICU) was conducted. Compared with ICU patients, non-ICU patients had a higher comorbidity burden (median Charlson comorbidity index [CCI] 6 vs 5 in ICU patients, P = .006). Hematologic and oncologic malignancies were more frequent among non-ICU cases (45.5% vs 28.4%, P < .001), whereas both chronic kidney and cardiovascular disease were more prevalent in ICU patients (P < .001). Non-ICU patients had significantly lower mortality in Kaplan–Meier survival analysis (P > .001). Postsurgical non-ICU patients (n = 45) had the highest survival rate (73.3%, P = .003) and the longest hospital stay, even after excluding all cases with a fatal outcome before day 30. In non-ICU patients, older age, hemato-oncologic malignancies, chronic liver disease, and COVID-19 were all independently associated with mortality risk, while treatment consultation by an infectious disease or clinical microbiology consultant, and initial treatment with an echinocandin, respectively, higher EQUAL Candida scores were associated with lower mortality risk in the multivariable Cox regression models. In conclusion, despite higher comorbidity rates, non-ICU patients with candidemia had higher survival rates.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Research Institutes & Centres > Centre for Trials Research (CNTRR) Schools > Medicine
Publisher:	Oxford University Press
ISSN:	2328-8957
Date of First Compliant Deposit:	26 October 2026
Date of Acceptance:	5 March 2026
Last Modified:	26 Oct 2026 14:49
URI:	https://orca.cardiff.ac.uk/id/eprint/190422

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