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This study aimed to evaluate temporal changes in species distribution, antifungal resistance, clinical outcomes, and mortality predictors in ICU patients with candidemia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective study included 250 ICU patients with candidemia between January 2018 and January 2022. The study period was divided into two cohorts (2018\u20132020,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200980; 2020\u20132022,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009170). Clinical, laboratory, and microbiological characteristics were compared. Multivariable analysis was performed to identify independent predictors of mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The incidence density of candidemia significantly decreased from 4.32 to 3.10 per 1,000 ICU patient-days (IRR: 0.72; %95 CI: 0.55\u20130.94;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090,014). A shift toward non-albicans\n                      <jats:italic>Candida<\/jats:italic>\n                      species was observed, while antifungal resistance rates remained stable. Candida score values and empirical antifungal therapy rates were lower in the later period. Despite increased central venous catheter use, catheter-related candidemia decreased. Overall mortality was similar between periods; however, during the second period, mortality was higher in patients with SARS-CoV-2 infection than in those without infection [100\/105 (95.2%) vs. 43\/65 (66.2%),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001]. In multivariable analysis, SOFA score was independently associated with mortality in the early period (OR: 1.20, 95% CI: 1.01\u20131.43;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.043), whereas SARS-CoV-2 infection (OR: 20.43, 95% CI: 3.53\u2013118.14;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), Candida score (OR: 0.19, 95% CI: 0.06\u20130.50;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003), lactate level at ICU admission (OR: 5.23, 95% CI: 1.55\u201317.57;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007), and urea level at ICU admission (OR: 1.01, 95% CI: 1.00\u20131.02;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.030) were independent predictors in the later period.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The high mortality observed among patients with SARS-CoV-2\u2013associated candidemia underscores the need for heightened diagnostic awareness in deteriorating ICU patients. Early diagnostic work-up, timely initiation of antifungal therapy, and reassessment of treatment according to microbiological findings are important in this setting. Hospital-specific identification of preventable risk factors may also help optimize candidemia management and infection control strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-026-13759-9","type":"journal-article","created":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T12:25:19Z","timestamp":1780748719000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Temporal changes in mortality and risk factors of candidemia in intensive care unit patients"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8524-8907","authenticated-orcid":false,"given":"Burak","family":"Kizilcay","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1097-9465","authenticated-orcid":false,"given":"Zeynep","family":"Cizmeci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3218-0029","authenticated-orcid":false,"given":"Gulsum Oya","family":"Hergunsel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8893-3977","authenticated-orcid":false,"given":"Zafer","family":"Cukurova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2963-4894","authenticated-orcid":false,"given":"Kadriye","family":"Kart Yasar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7210-1084","authenticated-orcid":false,"given":"Zuhal","family":"Yesilbag","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,6]]},"reference":[{"issue":"1","key":"13759_CR1","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1186\/s13054-019-2497-3","volume":"23","author":"M Bassetti","year":"2019","unstructured":"Bassetti M, Giacobbe DR, Vena A, Trucchi C, Ansaldi F, Antonelli M, et al. 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