Candidemia in Turkey demonstrates nationwide predominance of non-albicans Candida and Candida auris detection

In recent years, evolving patterns in candidemia epidemiology, including increasing proportions of non-albicans Candida (NAC) species and the emergence of Candida auris, have been reported. We aimed to characterize contemporary candidemia epidemiology in Turkey and to assess the association between guideline adherence and 30-day mortality. In this nationwide retrospective multicenter cohort study, adult patients with blood culture-confirmed candidemia diagnosed between January 2022 and December 2023 in 20 hospitals were included. Species identification was standardized and confirmed using MALDI-TOF MS. A total of 398 candidemia episodes were analyzed. Although Candida albicans remained the single most common species (34.7%), NAC species predominated overall (65.3%), mainly driven by Candida parapsilosis (26.6%), while C. auris accounted for 6.5% of cases and was detected across multiple centers. Crude mortality was 68.3% and 30-day mortality was 56.3%. Failure to remove central venous catheters (CVC) was independently associated with higher 30-day mortality. Kaplan-Meier analysis demonstrated significant differences in 30-day survival across EQUAL Candida score categories in the overall candidemia cohort (log-rank p = 0.02) and among patients with CVC-related candidemia cohort (log-rank p = 0.008). Collectively, our findings provide a contemporary nationwide overview of candidemia in Turkey, highlighting the predominance of NAC species, the multicenter detection of C. auris, and the clinical importance of early source control.

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Journal
Scientific Reports
Published
2026-05-30
DOI
https://doi.org/10.1038/s41598-026-53506-3
Primary Topic
Antifungal resistance and susceptibility
Type
article
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article

Candidemia in Turkey demonstrates nationwide predominance of non-albicans Candida and Candida auris detection

Bedia Dinç, Aynur Gülcan, Nisel Yılmaz, Nida Özcan et al.
Scientific Reports
Antifungal resistance and susceptibility
article

Candidemia in Turkey demonstrates nationwide predominance of non-albicans Candida and Candida auris detection

Bedia Dinç, Aynur Gülcan, Nisel Yılmaz, Nida Özcan, Birsen Mutlu, Zeynep Çizmeci, Zühal Yeşilbağ, Duru Mistanoglu-Ozatag, Zehra Çağla Karakoç, Füsun Can, Oğuz Usta, İlkay Karaoğlan, Suheyla Serin-Senger, Yasemin Tezer, Zeynep Karakaşoğlu, Serap Demir-Tekol, Elif Neyligül Arslan, Ayşe Barış, Handan Alay, Emine Günal, Önder Ergönül, Melih Uygun, Müge Aslan, Ayşe Serra Özel, Begüm Nalça, Buket Ertürk-Şengel, Özlem Güler, KLİMİK MİÇG Study Group, Ebru Taşpınar-Şen, Recep Tekin, Yasemin Zer, Esra Kazak, Neşe Saltoğlu, Feyzanur Gündoğdu-Aksoy, Elif Seren Tanrıverdi, Pınar Elbir-Kılıç, Sibel Bolukçu, Didem Akal-Taşçıoğlu, Funda Memişoğlu, Beyza Ener, İlvana Çaklovica-Küçükkaya
article en

Abstract

In recent years, evolving patterns in candidemia epidemiology, including increasing proportions of non-albicans Candida (NAC) species and the emergence of Candida auris, have been reported. We aimed to characterize contemporary candidemia epidemiology in Turkey and to assess the association between guideline adherence and 30-day mortality. In this nationwide retrospective multicenter cohort study, adult patients with blood culture-confirmed candidemia diagnosed between January 2022 and December 2023 in 20 hospitals were included. Species identification was standardized and confirmed using MALDI-TOF MS. A total of 398 candidemia episodes were analyzed. Although Candida albicans remained the single most common species (34.7%), NAC species predominated overall (65.3%), mainly driven by Candida parapsilosis (26.6%), while C. auris accounted for 6.5% of cases and was detected across multiple centers. Crude mortality was 68.3% and 30-day mortality was 56.3%. Failure to remove central venous catheters (CVC) was independently associated with higher 30-day mortality. Kaplan-Meier analysis demonstrated significant differences in 30-day survival across EQUAL Candida score categories in the overall candidemia cohort (log-rank p = 0.02) and among patients with CVC-related candidemia cohort (log-rank p = 0.008). Collectively, our findings provide a contemporary nationwide overview of candidemia in Turkey, highlighting the predominance of NAC species, the multicenter detection of C. auris, and the clinical importance of early source control.

Scientific Reports
Dicle University (TR), Bursa Uludağ Üni̇versi̇tesi̇ (TR), Izmir University (TR), Koç University (TR), Bilkent University (TR), University of Health Science (KH), Inonu University (TR), Kütahya Dumlupınar Üniversitesi (TR), Memorial Ankara Hospital (TR), Dr Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi (TR), Ümraniye Eğitim ve Araştırma Hastanesi (TR), Istanbul University-Cerrahpaşa (TR), Istinye University (TR), Bakırköy Dr.Sadi Konuk Eğitim ve Araştırma Hastanesi (TR), Sağlık Bilimleri Üniversitesi (TR), Istanbul Eye Hospital (TR), University Clinical Center Tuzla (BA), Şişli Etfal Eğitim ve Araştırma Hastanesi (TR), Ankara Bilkent City Hospital (TR), Kocaeli Üniversitesi (TR), Gaziantep University (TR), Atatürk University (TR), Istanbul University (TR), Marmara University (TR), University of Health Sciences Antigua (AG)
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