The Influence of the Seasonal Variability of <i>Candida</i> 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 ev...

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Main Authors: Paola Di Carlo, Nicola Serra, Ornella Collotta, Claudia Colomba, Alberto Firenze, Luigi Aprea, Salvatore Antonino Distefano, Andrea Cortegiani, Giovanni Giammanco, Teresa Maria Assunta Fasciana, Roberta Virruso, Angela Capuano, Consolato M. Sergi, Antonio Cascio
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Antibiotics
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Online Access:https://www.mdpi.com/2079-6382/14/5/452
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Summary:<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.
ISSN:2079-6382