Increased incidence of candidemia in a tertiary care hospital with the COVID‐19 pandemic

• Published in: Mycoses Vol. 64; no. 2; pp. 152 - 156
• Main Authors: Nucci, Marcio, Barreiros, Gloria, Guimarães, Luiz Felipe, Deriquehem, Vitor A.S., Castiñeiras, Anna Carla, Nouér, Simone A.
• Format: Journal Article Web Resource
• Language: English
• Published: Germany John Wiley & Sons, Inc 01.02.2021; Wiley Subscription Services, Inc; John Wiley and Sons Inc
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Brazil - epidemiology; Candida; Candida - genetics; Candida - isolation & purification; Candida - physiology; Candidemia; Candidemia - epidemiology; Candidemia - etiology; Candidemia - microbiology; COVID-19; COVID-19 - complications; COVID-19 - epidemiology; COVID-19 - virology; deep fungal infection; epidemiology; Female; Hospitalization; Humans; Male; Mechanical ventilation; Middle Aged; Original; Pandemics; SARS-CoV-2 - physiology; systemic infection; Tertiary Care Centers - statistics & numerical data; Young Adult; Brazil; epidemiology; systemic infection; candidemia; Candida; deep fungal infection
• ISSN: 0933-7407; 1439-0507
• DOI: 10.1111/myc.13225

Background The incidence of candidemia in our hospital has been stable over an 18‐year period (1.3 episodes per 1000 admissions). Since March 2020, we have observed an increase in cases of candidemia. Methods In March 2020, the hospital was prepared to receive patients with COVID‐19, with cancellation of elective procedures, discharge of less sick patients and the activation of beds for COVID‐19. We compared the incidence of candidemia in 2 periods: from January 2019 to February 2020 (period 1) and from March to September 2020 (period 2). Results We diagnosed 41 episodes of candidemia, 16 in period 1 and 25 in period 2 (9 COVID‐19 patients). Compared with non‐COVID‐19 patients, COVID‐19 patients with candidemia were more likely to be under mechanical ventilation (100% vs. 34.4%, P < .001). The median number of monthly admissions in period 1 and 2 was 723 (interquartile range 655‐836) and 523 (interquartile range 389‐574), respectively. The incidence of candidemia (per 1000 admissions) was 1.54 in period 1 and 7.44 in period 2 (P < .001). In period 2, the incidence of candidemia (per 1000 admissions) was 4.76 if we consider only cases of candidemia in non‐COVID‐19 patients, 2.68 if we consider only cases of candidemia in COVID‐19 patients and 14.80 considering only admissions of patients with COVID‐19. Conclusions The increase in the incidence of candidemia in our hospital may be attributed to 2 factors: a reduction in the number of admissions (denominator) and the occurrence of candidemia in COVID‐19 patients.