CAMEO—a cross-sectional survey study on candidemia management in Germany

Candida species cause life-threatening bloodstream infections, particularly in critically ill and immunocompromised patients. Although guideline adherence has been shown to improve outcomes, real-world implementation is often constrained. This cross-sectional, web-based survey evaluated current clinical practices and barriers in candidemia management across German healthcare institutions. A structured questionnaire based on the EQUAL Candida score was disseminated online from 10/2023 to 07/2025. Physicians involved in candidemia management reported institutional characteristics, diagnostic practices, antifungal treatment strategies, central line management, and follow-up practices. Data were analyzed using descriptive statistics and chi-square testing. A total of 217 physicians from 147 institutions participated, with 74.5% of participants affiliated with large care facilities. Caspofungin was the predominant first-line therapy (81.4%), whereas fluconazole was used by 5.3% of participants. First-line choice did not differ by years of clinical experience (P = 0.194). Echocardiography was routinely performed by 57% of participants; selective use showed no association with years of clinical experience (P = 0.845) or annual number of candidemia cases (P = 0.089). Ophthalmoscopy was performed routinely by 37% of participants and showed no association with experience (P = 0.907), but was significantly associated with lower annual caseload (P = 0.02) and infectious disease speciality (P = 0.003). Central line removal or replacement within 24 h was reported by 82.5%. Follow-up blood cultures were obtained daily by 31.4%, while 54.8% repeated cultures every 48 h. While core candidemia management practices are generally well implemented in German healthcare institutions, certain recommended diagnostic steps remain underutilized. Targeted educational and structural interventions are needed to strengthen guideline adherence and optimize patient outcomes across diverse settings.

Authors

Institutions

Publication Details

Journal
Medical Mycology
Published
2026-04-22
DOI
https://doi.org/10.1093/mmy/myag038
Primary Topic
Antifungal resistance and susceptibility
Type
article
Field-Weighted Citation Impact
0.00

Funders

Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

CAMEO—a cross-sectional survey study on candidemia management in Germany

Stefan Borgmann, Christian Giesa, Oliver Kriege, Anna Philine Karl et al.
Medical Mycology
Antifungal resistance and susceptibility
article

CAMEO—a cross-sectional survey study on candidemia management in Germany

Stefan Borgmann, Christian Giesa, Oliver Kriege, Anna Philine Karl, Till Eßlinger, Clemens Gießen-Jung, Oana Joean, Danila Seidel, Christian Eckmann, André Fuchs, Antonios Katsounas, Pia Hartmann, Mark Oette, Christian Lanckohr, Nils Kellner, Rika Draenert, Reinhard Berner, Maximilian Christopeit, Ilana Reinhold, Andreas H. Groll, Sven Breitschwerdt, Jannik Stemler, Elham Khatamzas, Jens M. Poth, Gernot Beutel, Ulrich Pecks, Ioana D. Olaru, Larissa Henze, Rudolf Baloun, Nicola Giesen, Jürgen Held, Sabine Recknagel-Friese, Heike Kneifel, Wilfried Obst, Bahman Gharavi, Kristina E. Fuest, Rosanne Sprute, Jon Salmanton‐García, Cathrin Kodde, Jan Ramming, Sören L. Becker, Julia Fischer, Oliver A. Cornely, Christina Bahrs, Tobías Manuel Appel, Hendrik Bracht, Gesa-Henrike Nawrot, Anette Friedrichs, M. Grade, Luise Martin, Janina Leckler, Sebastian Dolff, Sarina Butzer, Christian Beyer, Michael Kiehl, Peter‐Michael Rath, Meinolf Karthaus, Albert Wahl, Karla Boos, Rehsan Akdas, Stefan Ehrentraut, Daniel Grimm, Patricia Horn, Christina Bähr, Rudolf Eicker, the CAMEO collaborator group, Laura Fischer, André Oberthür, Wolfgang Kruger, Anna Köster, Lukas Herrmann, Johanna Jank, Katrin Dannenberg, Michal Moser, Alexandra Esser-Budde, Parviz Aliyev, Björn Jensen, Thomas Reichel, Christoph Ammer-Herrmenau, William Krüger, Dominic Preuß, Fränze Helming, Lukas Matthias Langner, Christine Becket, Muhannad Darkazanli, Anke Hildebrandt, Gregor Massoth, Lampros Kousoulad, Lisa Meinker, André Jakob, Kay-Karsten Kober, Mathias Pletz, Maike Rebenstorff, Judith Lindert, Julia Eßer, Torben Esser, Thomas Abele, Evgeniya Chasovnikova, Johannes Liese, Jannik Fasse
article en

Abstract

Candida species cause life-threatening bloodstream infections, particularly in critically ill and immunocompromised patients. Although guideline adherence has been shown to improve outcomes, real-world implementation is often constrained. This cross-sectional, web-based survey evaluated current clinical practices and barriers in candidemia management across German healthcare institutions. A structured questionnaire based on the EQUAL Candida score was disseminated online from 10/2023 to 07/2025. Physicians involved in candidemia management reported institutional characteristics, diagnostic practices, antifungal treatment strategies, central line management, and follow-up practices. Data were analyzed using descriptive statistics and chi-square testing. A total of 217 physicians from 147 institutions participated, with 74.5% of participants affiliated with large care facilities. Caspofungin was the predominant first-line therapy (81.4%), whereas fluconazole was used by 5.3% of participants. First-line choice did not differ by years of clinical experience (P = 0.194). Echocardiography was routinely performed by 57% of participants; selective use showed no association with years of clinical experience (P = 0.845) or annual number of candidemia cases (P = 0.089). Ophthalmoscopy was performed routinely by 37% of participants and showed no association with experience (P = 0.907), but was significantly associated with lower annual caseload (P = 0.02) and infectious disease speciality (P = 0.003). Central line removal or replacement within 24 h was reported by 82.5%. Follow-up blood cultures were obtained daily by 31.4%, while 54.8% repeated cultures every 48 h. While core candidemia management practices are generally well implemented in German healthcare institutions, certain recommended diagnostic steps remain underutilized. Targeted educational and structural interventions are needed to strengthen guideline adherence and optimize patient outcomes across diverse settings.

Medical MycologyVol. 64(5)
University of Cologne (DE), German Center for Infection Research (DE), Cologne Excellence Cluster on Cellular Stress Responses in Aging Associated Diseases (DE), University Hospital Cologne (DE)
Mundipharma Research Limited
Openalex Percentile: Top 19%
Antifungal resistance and susceptibility
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.