Subject(s)
COVID-19/complications , Candidemia/virology , Coinfection/diagnosis , Aged, 80 and over , Antifungal Agents/pharmacology , Antifungal Agents/therapeutic use , Candida/drug effects , Candidemia/diagnosis , Candidemia/drug therapy , Candidemia/immunology , Carcinoma, Squamous Cell/complications , Carcinoma, Squamous Cell/surgery , Coinfection/microbiology , Coinfection/virology , Drug Resistance, Fungal , Fatal Outcome , Female , HumansABSTRACT
The epidemiology and mycology of invasive candidiasis in the ICU is well-described in certain types of critically ill patients but not in others. One population that has been scarcely studied is non-neutropenic patients admitted specifically to medical ICUs. Even less is known about the broader category of medical ICU patients without active oncological disease. This group constitutes a very large share of the patients requiring critical care across the globe, especially in the era of the SARS-CoV-2 pandemic. We analysed medical ICU candidaemia episodes that occurred in non-oncological patients in our tertiary academic centre in the United States from May 2014 to October 2020 to determine the incidence and species distribution of the associated isolates. We then separately considered non-COVID-19 and COVID-19 cases and compared their characteristics. In the non-COVID-19 group, there were 38 cases for an incidence of 1.1% and rate of 11/1000 admissions. In the COVID-19 group, there were 12 cases for an incidence of 5.1% and rate of 51/1000 admissions. In the entire sample, as well as separately in the non-COVID-19 and COVID-19 groups,Candida albicans accounted for a minority of isolates. Compared to non-COVID-19 patients with candidaemia, COVID-19 patients had lower ICU admission SOFA score but longer ICU length of stay and central venous catheter dwell time at candidaemia detection. This study provides valuable insight into the incidence and species distribution of candidaemia cases occurring in non-oncological critically ill patients and identifies informative differences between non-COVID-19 and COVID-19 patients.
Subject(s)
COVID-19/epidemiology , COVID-19/microbiology , Candidemia/epidemiology , Candidemia/microbiology , Candidemia/virology , Adult , Aged , Candida/isolation & purification , Critical Care , Critical Illness , Female , Humans , Incidence , Intensive Care Units , Male , Middle Aged , SARS-CoV-2/isolation & purification , Tertiary Care Centers , United States/epidemiologyABSTRACT
We report the successful management of a patient with severe respiratory failure due to COVID-19 admitted to an intensive care unit complicated by secondary catheter-related infection of Candida glabrata. We are discussing some of the clinical challenges and the pitfalls in molecular diagnosis of SARS-CoV-2, including the fact that a positive PCR result may not always reflect infectiousness.