{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T13:51:32Z","timestamp":1787061092432,"version":"build-2736575974"},"reference-count":34,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,4,8]],"date-time":"2021-04-08T00:00:00Z","timestamp":1617840000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Deputy of Research of Mashhad University of Medical Sciences","award":["991949"],"award-info":[{"award-number":["991949"]}]},{"name":"National Institutes of Medical Research Development Grant\/ Award","award":["982822"],"award-info":[{"award-number":["982822"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>As a novel risk factor, COVID-19 has led to an increase in the incidence of candidemia and an elevated mortality rate. Despite being of clinical importance, there is a lack of data regarding COVID-19-associated candidemia (CAC) among Iranian patients. Therefore, in this retrospective study, we assessed CAC epidemiology in the intensive care units (ICUs) of two COVID-19 centers in Mashhad, Iran, from early November 2020 to late January 2021. Yeast isolates from patients\u2019 blood were identified by 21-plex polymerase chain reaction (PCR) and sequencing, then subjected to antifungal susceptibility testing according to the CLSI M27-A3 protocol. Among 1988 patients with COVID-19 admitted to ICUs, seven had fungemia (7\/1988; 0.03%), among whom six had CAC. The mortality of the limited CAC cases was high and greatly exceeded that of patients with COVID-19 but without candidemia (100% (6\/6) vs. 22.7% (452\/1988)). In total, nine yeast isolates were collected from patients with fungemia: five Candida albicans, three C. glabrata, and one Rhodotorula mucilaginosa. Half of the patients infected with C. albicans (2\/4) were refractory to both azoles and echinocandins. The high mortality of patients with CAC, despite antifungal therapy, reflects the severity of the disease in these patients and underscores the importance of rapid diagnosis and timely initiation of antifungal treatment.<\/jats:p>","DOI":"10.3390\/jof7040280","type":"journal-article","created":{"date-parts":[[2021,4,8]],"date-time":"2021-04-08T11:58:45Z","timestamp":1617883125000},"page":"280","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":67,"title":["Candidemia among Iranian Patients with Severe COVID-19 Admitted to ICUs"],"prefix":"10.3390","volume":"7","author":[{"given":"Amir","family":"Arastehfar","sequence":"first","affiliation":[{"name":"Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tahmineh","family":"Shaban","sequence":"additional","affiliation":[{"name":"Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad 9199-91766, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1449-4668","authenticated-orcid":false,"given":"Hossein","family":"Zarrinfar","sequence":"additional","affiliation":[{"name":"Allergy Research Center, Mashhad University of Medical Sciences, Mashhad 91766-99199, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Roudbary","sequence":"additional","affiliation":[{"name":"Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran 1449614535, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3045-9125","authenticated-orcid":false,"given":"Mona","family":"Ghazanfari","sequence":"additional","affiliation":[{"name":"Invasive Fungi Research Center, Communicable Diseases Research Institute, Mazandaran University of Medical Sciences, Sari 48157-33971, Iran"},{"name":"Department of Medical Mycology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari 48157-33971, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad-Taghi","family":"Hedayati","sequence":"additional","affiliation":[{"name":"Invasive Fungi Research Center, Communicable Diseases Research Institute, Mazandaran University of Medical Sciences, Sari 48157-33971, Iran"},{"name":"Department of Medical Mycology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari 48157-33971, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alireza","family":"Sedaghat","sequence":"additional","affiliation":[{"name":"Lung Diseases Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad 9137913316, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1174-4182","authenticated-orcid":false,"given":"Macit","family":"Ilkit","sequence":"additional","affiliation":[{"name":"Division of Mycology, University of \u00c7ukurova, Adana 01330, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Javad","family":"Najafzadeh","sequence":"additional","affiliation":[{"name":"Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad 9199-91766, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S.","family":"Perlin","sequence":"additional","affiliation":[{"name":"Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/j.cmi.2020.10.021","article-title":"Secondary infections in patients hospitalized with COVID-19: Incidence and predictive factors","volume":"27","author":"Ripa","year":"2021","journal-title":"Clin. 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