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@ARTICLE{Wolf:300232,
      author       = {S. Wolf$^*$ and S. Weber$^*$ and A. Janetta and F. Klein
                      and J. Enssle$^*$ and M. Hogardt and V. A. J. Kempf and J.
                      Kessel and M. J. G. T. Vehreschild and B. Steffen and T.
                      Oellerich$^*$ and H. Serve$^*$ and S. Scheich$^*$},
      title        = {{E}pidemiology and outcomes of {C}andida spp. bloodstream
                      infections in cancer patients: a comparative retrospective
                      study from a {G}erman tertiary cancer center.},
      journal      = {Infection},
      volume       = {nn},
      issn         = {0300-8126},
      address      = {München},
      publisher    = {Urban $\&$ Vogel},
      reportid     = {DKFZ-2025-00694},
      pages        = {nn},
      year         = {2025},
      note         = {epub},
      abstract     = {Bloodstream infections (BSI) due to Candida spp.
                      significantly contribute to morbidity and mortality among
                      cancer patients. Understanding their clinical course, risk
                      factors, and outcomes compared to bacterial BSI is
                      essential.We aim to elucidate the epidemiology and risk
                      factors associated with Candida BSI compared to bacterial
                      BSI in cancer patients.We analyzed epidemiological data of
                      Candida BSI versus bacterial BSI among cancer patients,
                      primarily with hematological malignancies. Blood cultures
                      were obtained upon clinical suspicion, with species
                      identification by VITEK 2 and MALDI-TOF. Susceptibility
                      testing utilized VITEK 2 or antibiotic gradient
                      tests.Candida BSI was associated with higher 30-day
                      mortality compared to bacterial BSI (Hazard ratio (HR) 4.5,
                      $95\%$ CI 2.5-8.1, p < 0.001) occurring predominantly in
                      patients with relapsed/refractory disease. Univariate
                      analysis identified risk factors for Candida BSI:
                      hypoalbuminemia (Odds ratio (OR) 9.13, $95\%$ CI 2.7-57, p =
                      0.003), prior ICU/MC stay (OR 3.91, $95\%$ CI 1.38-9.65, p =
                      0.005), palliative treatment (OR 3.42, $95\%$ CI 1.52-7.4, p
                      = 0.002), parenteral nutrition (OR 2.44, $95\%$ CI 0.9-5.5,
                      p = 0.039) and prior allogeneic HSCT (OR 2.28, $95\%$ CI
                      0.92-5.13, p = 0.056). Risk factors identified by
                      multivariate analysis were palliative therapy (OR 5.23,
                      $95\%$ CI 3.14-8.71, p = 0.001), hypoalbuminemia (OR 9.02,
                      $95\%$ CI 4.23-19.2, p = 0.004), and prior ICU/IMC stay (OR
                      4, $95\%$ CI 2.31-6.92, p = 0.011). In patients with
                      confirmed Candida BSI, delayed initiation of antifungal was
                      associated with worse outcomes.Compared to bacterial BSI
                      events, Candida BSI are associated with significantly higher
                      30-day mortality, primarily affecting heavily pretreated
                      patients with relapsed or refractory disease.},
      keywords     = {Candida (Other) / Acute leukemia (Other) / Bloodstream
                      infection (Other) / Hematology (Other) / Neutropenic fever
                      (Other) / Oncology (Other)},
      cin          = {FM01},
      ddc          = {610},
      cid          = {I:(DE-He78)FM01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40175754},
      doi          = {10.1007/s15010-025-02513-z},
      url          = {https://inrepo02.dkfz.de/record/300232},
}