{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T20:33:55Z","timestamp":1790195635839,"version":"4.1.0"},"reference-count":29,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Fungi","JoF"],"abstract":"<jats:p>Background: In catheter-related candidemia, a true catheter-source infection is often difficult to distinguish from a catheter that merely marks critical illness. Our primary aim was to identify predictors of 30-day mortality; secondary aims were to characterize species-specific patterns of persistent candidemia, its prognostic meaning within the host immune\u2013inflammatory context, and the relationship between echinocandin therapy and secondary bacterial bloodstream infection (BSI). Methods: We retrospectively reviewed 89 consecutive episodes of catheter-related candidemia at Bursa City Hospital (2021\u20132025). Catheter association required Candida spp. growth in concurrent catheter and peripheral blood cultures. The primary endpoint was 30-day mortality; persistent candidemia (\u226572 h) and secondary bacterial BSI on days 3\u201330 were evaluated as exploratory endpoints. Raw MIC values were retrospectively reinterpreted according to EUCAST v12.1 breakpoints (effective 10 April 2026). Results: Thirty-day mortality was 53.9% (48\/89). The multivariable model was significant (LR \u03c72 = 12.12, df = 4, p = 0.017; Nagelkerke R2 = 0.170); NLR was not significantly associated with mortality (OR = 1.061, 95% CI 1.00\u20131.13, p = 0.064). Catheter removal, initial echinocandin therapy, and persistent candidemia were not independent predictors, though catheter retention was associated with higher mortality on univariable analysis (83.3%; p = 0.033). Persistent candidemia occurred in 51.7% of episodes, most notably with C. parapsilosis and C. auris. The NLR-persistence interaction was not formally significant, but mortality was higher when both co-occurred (66.7% vs. 36.4%; OR = 3.50, p = 0.075). Secondary BSI occurred in 28.4% of episodes and was more frequent in the echinocandin group (39% vs. 20%; p = 0.062); sensitivity analyses did not change the main findings. Conclusions: Mortality could not be explained by antifungal choice alone; these findings are exploratory. Host response, source control, species distribution, survival time, and device exposure are possible contributing factors warranting evaluation in prospective studies.<\/jats:p>","DOI":"10.3390\/jof12080563","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T11:50:21Z","timestamp":1785757821000},"page":"563","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Persistence, Source Control, and Secondary Bacterial Bloodstream Infection in Catheter-Related Candidemia: A Retrospective Cohort Study"],"prefix":"10.3390","volume":"12","author":[{"given":"Emel","family":"G\u00fcrc\u00fco\u011flu","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases and Clinical Microbiology, Bursa City Hospital, Bursa 16250, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0053-9087","authenticated-orcid":false,"given":"G\u00fclbahar","family":"\u00c7al\u0131\u015fkan","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Bursa City Hospital, Bursa 16250, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3454-5549","authenticated-orcid":false,"given":"M\u00fczeyyen Tu\u011f\u00e7e","family":"Benli","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Clinical Microbiology, Bursa City Hospital, Bursa 16250, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2475-5956","authenticated-orcid":false,"given":"Demet","family":"Timur","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Bursa City Hospital, Bursa 16250, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1186\/s13054-019-2497-3","article-title":"Incidence and outcome of invasive candidiasis in intensive care units (ICUs) in Europe: Results of the EUCANDICU project","volume":"23","author":"Bassetti","year":"2019","journal-title":"Crit. 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