The Influence of the Seasonal Variability of Candida spp. Bloodstream Infections and Antifungal Treatment: A Mediterranean Pilot Study

<b>Background/Objectives</b>: Various factors associated with seasonality, including temperature, humidity, geographical composition, and seasonal fluctuations, can influence the trends of microbes responsible for hospital infections, such as <i>Candida</i> spp. This study evaluates the seasonal variability of Candida spp. bloodstream infections and antifungal resistance in hospitalized patients in Sicily. <b>Methods</b>: We retrospectively analyzed the demographic and epidemiological characteristics of 175 patients with blood cultures positive for <i>Candida</i> spp. Who were hospitalized at University Hospital Paolo Giaccone (A.U.O.P.), University of Palermo, Italy, from 1 January 2022 to 31 December 2024. Data on <i>Candida</i> species and antifungal resistance were also collected from the hospital's database system to prevent and control hospital infections in A.U.O.P. <b>Results</b>: A total of 175 patients, 57.7% males, with a mean age of 68.3 years, were included in this study. <i>Candida</i> <i>parapsilosis</i>, <i>Candida albicans</i>, and <i>Candida glabrata</i> were more frequent in ICU (54.5%, <i>p</i> = 0.0001), medical (72.5%, <i>p</i> = 0.0003), and surgical settings (24%, <i>p</i> = 0.0161), respectively. <i>C.</i> <i>parapsilosis was</i> more frequent in dead patients (53.2%, <i>p</i> = 0.005). Among the seasons, we observed a significantly higher presence of <i>C. glabrata</i> in Autumn (20%, <i>p</i> = 0.0436). From the analysis of the seasons, <i>C</i>. <i>parapsilosis</i> and <i>C</i>. albicans were more frequent for each season, except in Spring, where the most frequent isolates were <i>C</i>. <i>glabrata</i> (5.1%, <i>p</i> = 0.0237) and C. <i>parapsilosis</i> (9.7%, <i>p</i> < 0.0001). The antifungal with the most resistance to <i>Candida</i> spp. was fluconazole in all seasons. <b>Conclusions</b>: Our study highlights the seasonal trends in <i>Candida</i> spp. and antifungal resistance, emphasizing climate change's challenges on fungal diseases. These findings may contribute to improving prevention and treatment strategies for candidemia.