{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T20:10:24Z","timestamp":1791835824525,"version":"4.3.4"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>This multicentre retrospective study investigated the epidemiology, clinical characteristics, and fluconazole resistance rates of Candida species in osteoarticular infections across Turkey as well as the factors influencing complete recovery. Data were gathered from 73 adult patients diagnosed with proven or probable Candida-associated osteoarticular infections between 2015 and 2025 from 20 healthcare centres. The most common clinical presentation was spondylodiscitis, followed by the involvement of phalangeal bones in the hands and feet. Non-albicans Candida species accounted for 37\/73 cases (50.7%), with Candida parapsilosis being the most frequent. Fluconazole resistance was low among Candida albicans isolates (3%) but higher among non-albicans yeasts (27%). Bacterial co-infection, predominantly Gram-positive bacteria, was detected in 52.1% of cases. Diabetes was present in 50\/73 patients (68.5%), particularly insulin-dependent diabetes, and was a prominent comorbidity that may have also contributed as a predisposing factor. Radiological detection of osteomyelitis was achieved in 69.9% of patients. Fluconazole was the most commonly used antifungal agent (74%) with a median treatment duration of 90 days. Multivariate analysis revealed that surgical debridement was significantly associated with a higher odds of clinical recovery (adjusted odds ratio [aOR], 5.764; 95% confidence interval [CI], 1.360\u201324.434; p\u00a0=\u00a00.017), whereas diabetes mellitus was significantly associated with a lower odds of total recovery (aOR, 0.205; 95% CI, 0.053\u20130.792; p\u00a0=\u00a00.022). In conclusion, this multicentre study provides epidemiological data and fluconazole resistance rates of Candida species causing osteoarticular infections in Turkey, highlights the occurrence of C. auris in this cohort, identifies surgical intervention and diabetes mellitus as factors significantly associated with recovery.<\/jats:p>","DOI":"10.1093\/mmy\/myaf080","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T12:48:14Z","timestamp":1756730894000},"source":"Crossref","is-referenced-by-count":1,"title":["Epidemiology and Outcomes of <i>Candida<\/i>-Associated Osteoarticular Infections: A Multicenter Retrospective Study from Turkey"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7018-7224","authenticated-orcid":false,"given":"\u00d6zlem","family":"G\u00fcler","sequence":"first","affiliation":[{"name":"Kocaeli University, Faculty of Medicine Assistant Professor, Department of Infectious Diseases and Clinical Microbiology, , Kocaeli ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murat","family":"\u00dczel","sequence":"additional","affiliation":[{"name":"Hand Surgery, Kocaeli University Faculty of Medicine Professor, Department of Orthopaedics and Traumatology, , Kocaeli ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dil\u015fat","family":"TEPE","sequence":"additional","affiliation":[{"name":"Karadeniz Technical University, Faculty of Medicine Medical Doctor, Department of Infectious Diseases and Clinical Microbiology, , Trabzon ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Firdevs","family":"Aksoy","sequence":"additional","affiliation":[{"name":"Karadeniz Technical University, Faculty of Medicine Assistant Professor, Department of Infectious Diseases and Clinical Microbiology, , Trabzon ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00fcle","family":"\u00c7inar","sequence":"additional","affiliation":[{"name":"Ankara University, Faculty of Medicine Associate Professor, Department of Infectious Diseases and Clinical Microbiology, , Ankara ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kemal Osman","family":"Memiko\u011flu","sequence":"additional","affiliation":[{"name":"Ankara University, Faculty of Medicine Professor, Department of Infectious Diseases and Clinical Microbiology, , Ankara ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0244-4006","authenticated-orcid":false,"given":"B\u00fclent","family":"Durdu","sequence":"additional","affiliation":[{"name":"Bezmialem Vakif University, Faculty of Medicine Professor, Department of Infectious Diseases and Clinical Microbiology, , Istanbul 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,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ne\u015fe","family":"Salto\u011flu","sequence":"additional","affiliation":[{"name":"Istanbul University-Cerrahpa\u015fa, Cerrahpa\u015fa Faculty of Medicine Professor, Department of Infectious Diseases and Clinical Microbiology, , Istanbul ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derya","family":"Seyman","sequence":"additional","affiliation":[{"name":"Health Sciences University, Antalya Education and Research Hospital Professor, Department of Infectious Diseases and Clinical Microbiology, , Antalya ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I\u015f\u0131l Deniz","family":"Aliravci","sequence":"additional","affiliation":[{"name":"\u00c7anakkale 18 Mart University, Faculty of Medicine Assistant Professor, Department of Infectious Diseases and Clinical Microbiology, , \u00c7anakkale 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Abdulhamid Han Education and Research Hospital Medical Doctor, Department of Infectious Diseases and Clinical Microbiology, , Istanbul ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hatun","family":"\u00d6zt\u00fcrk \u00c7erik","sequence":"additional","affiliation":[{"name":"Ordu University, Faculty of Medicine Associate Professor, Department of Infectious Diseases and Clinical Microbiology, , Ordu ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selin","family":"\u00d6zdemir","sequence":"additional","affiliation":[{"name":"Health Sciences University, Izmir Bozyaka Education and Research Hospital Medical Doctor, Department of Infectious Diseases and Clinical Microbiology, , Izmir ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bet\u00fcl","family":"S\u00fcmer","sequence":"additional","affiliation":[{"name":"Erzincan Binali Y\u0131ld\u0131r\u0131m University, Meng\u00fccek Gazi Education and Research Hospital Medical Doctor, Department of Infectious Diseases and Clinical Microbiology, , Erzincan ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azize","family":"Yeti\u015fgen","sequence":"additional","affiliation":[{"name":"Turgut \u00d6zal University, Malatya Education and Research Hospital Medical Doctor, Department of Infectious Diseases and Clinical Microbiology, , Malatya ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6005-636X","authenticated-orcid":false,"given":"Ay\u015fe","family":"Batirel","sequence":"additional","affiliation":[{"name":"Health Sciences University, Kartal Dr. L\u00fctfi K\u0131rdar City Hospital Professor, Department of Infectious Diseases and Clinical Microbiology, , Istanbul ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ay\u015fe Serra","family":"\u00d6zel","sequence":"additional","affiliation":[{"name":"Health Sciences University, \u00dcmraniye Education and Research Hospital Associate Professor, Department of Infectious Diseases and Clinical Microbiology, , Istanbul ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4983-6613","authenticated-orcid":false,"given":"Seniha","family":"\u015eenbayrak","sequence":"additional","affiliation":[{"name":"Health Sciences University, Haydarpa\u015fa Numune Education and Research Hospital Professor, Department of Infectious Diseases and Clinical Microbiology, , Istanbul ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasemin T E Z E R","family":"Tek\u00e7e","sequence":"additional","affiliation":[{"name":"Health Sciences University, Ankara City Hospital Associate Professor, Department of Infectious Diseases and Clinical Microbiology, , Ankara ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zehra \u00c7a\u011fla","family":"Karako\u00e7","sequence":"additional","affiliation":[{"name":"Ist\u0131nye University, Faculty of Medicine Associate Professor, Department of Infectious Diseases and Clinical Microbiology, , Istanbul ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,9,1]]},"container-title":["Medical Mycology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/mmy\/advance-article-pdf\/doi\/10.1093\/mmy\/myaf080\/64171148\/myaf080.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/mmy\/advance-article-pdf\/doi\/10.1093\/mmy\/myaf080\/64171148\/myaf080.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T12:48:14Z","timestamp":1756730894000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/mmy\/advance-article\/doi\/10.1093\/mmy\/myaf080\/8245128"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,1]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/mmy\/myaf080","relation":{},"ISSN":["1369-3786","1460-2709"],"issn-type":[{"value":"1369-3786","type":"print"},{"value":"1460-2709","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,1]]},"article-number":"myaf080"}}