Trends in Candidemia Over the Last 14 Years: A Comparative Analysis of and .

Background: Data on the trends of the incidence of candidemia caused by and in recent years are very limited. At the same time, factors that predispose to candidemia, caused by both species and the epidemiology of hospital transmission, are not well known. Our study analyzed 14 years of candidemia in a single institution in order to compare the incidence, clinical outcomes, and transmission patterns of both species.

Methods: We conducted a retrospective study (2010-2023) in a 1236-bed tertiary hospital. We included all episodes of candidemia due to and and collected the epidemiological, clinical, and microbiological characteristics of the patients. Incidence trends were calculated per hospital admission and population. Antifungal susceptibility testing followed European Committee on Antimicrobial Susceptibility Testing guidelines, and genotyping used species-specific microsatellites.

Results: Among 576 episodes of candidemia, 269 (46.7%) were caused by and 110 (19.1%) by . The incidence of candidemia per 1000 admissions/y and 100 000 population/y remained stable for both species. affected younger patients with fewer comorbidities and lower mortality than . The catheter was the main source in both groups, but genotyping revealed no clusters, suggesting the absence of a significant horizontal transmission. We did not have a single episode of fluconazole-resistant candidemia.

Conclusions: Our data do not suggest an increasing trend in the incidence of and candidemia in recent years. Candidemia caused by both species is not significantly transmitted from patient to patient in the hospital. The genotypical distribution of fluconazole-resistant should be further studied.