{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T11:49:13Z","timestamp":1786708153880,"version":"build-2736575974"},"reference-count":33,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T00:00:00Z","timestamp":1739750400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","award":["FAPESP 2021\/10599-3"],"award-info":[{"award-number":["FAPESP 2021\/10599-3"]}]},{"name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","award":["PDSE 88881.187981\/2018-01"],"award-info":[{"award-number":["PDSE 88881.187981\/2018-01"]}]},{"DOI":"10.13039\/501100002322","name":"Antimicrobial Resistance Institute of S\u00e3o Paulo (ARIES) and CAPES Foundation","doi-asserted-by":"publisher","award":["FAPESP 2021\/10599-3"],"award-info":[{"award-number":["FAPESP 2021\/10599-3"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002322","name":"Antimicrobial Resistance Institute of S\u00e3o Paulo (ARIES) and CAPES Foundation","doi-asserted-by":"publisher","award":["PDSE 88881.187981\/2018-01"],"award-info":[{"award-number":["PDSE 88881.187981\/2018-01"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>Candidemia infection remains a critical challenge in intensive care units (ICUs), with high morbidity and mortality rates despite advances in therapeutic practices. This multicenter prospective surveillance study assessed the epidemiology, clinical management, and mortality predictors of candidemia in critically ill patients across two periods (2010\u20132012 and 2017\u20132018) in 11 tertiary hospitals in Brazil. Among 314 ICU patients with candidemia, the overall mortality rate was 60.2%, with no significant reduction over time (58.8% vs. 62.6%, p = 0.721). Candida albicans was the predominant pathogen (43.6%), followed by C. tropicalis (20%) and C. glabrata (13.7%). The use of echinocandins increased significantly in the second period (21.1% to 41.7%, p &lt; 0.001); however, 70% of patients still did not receive these agents as first-line therapy. Catheter removal due to candidemia was performed in only 52.1% of cases but was associated with improved 30-day survival (p &lt; 0.001). Multivariate analysis identified cancer, inadequate treatment, and vasoactive drug use as independent predictors of mortality. Our findings underscore persistent gaps in adherence to guidelines, particularly regarding timely echinocandin initiation and catheter removal. Strengthening therapeutic strategies focused on these key interventions is essential to improving outcomes for ICU patients with candidemia.<\/jats:p>","DOI":"10.3390\/jof11020152","type":"journal-article","created":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T07:48:22Z","timestamp":1739778502000},"page":"152","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Candidemia in ICU Patients: What Are the Real Game-Changers for Survival?"],"prefix":"10.3390","volume":"11","author":[{"given":"Bianca Leal","family":"de Almeida","sequence":"first","affiliation":[{"name":"Instituto do C\u00e2ncer do Estado de S\u00e3o Paulo, School of Medicine, Hospital Infection Control and Infectious Diseases Service, University of S\u00e3o Paulo, S\u00e3o Paulo 01246-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Agnelli","sequence":"additional","affiliation":[{"name":"Division 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