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Lookup NU author(s): Dr Manjusha Narayanan
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© The Author(s) 2026. Published by Oxford University Press on behalf of Infectious Diseases Society of America.The European Confederation of Medical Mycology Candida III was a pan-European, multicenter observational study of adult patients with blood culture–proven candidemia. Among a total of 632 patients with candidemia across 64 institutions in 20 European countries, a subanalysis of 396 (63%) cases occurring outside the intensive care unit (ICU) was conducted. Compared with ICU patients, non-ICU patients had a higher comorbidity burden (median Charlson comorbidity index [CCI] 6 vs 5 in ICU patients, P = .006). Hematologic and oncologic malignancies were more frequent among non-ICU cases (45.5% vs 28.4%, P < .001), whereas both chronic kidney and cardiovascular disease were more prevalent in ICU patients (P < .001). Non-ICU patients had significantly lower mortality in Kaplan–Meier survival analysis (P > .001). Postsurgical non-ICU patients (n = 45) had the highest survival rate (73.3%, P = .003) and the longest hospital stay, even after excluding all cases with a fatal outcome before day 30. In non-ICU patients, older age, hemato-oncologic malignancies, chronic liver disease, and COVID-19 were all independently associated with mortality risk, while treatment consultation by an infectious disease or clinical microbiology consultant, and initial treatment with an echinocandin, respectively, higher EQUAL Candida scores were associated with lower mortality risk in the multivariable Cox regression models. In conclusion, despite higher comorbidity rates, non-ICU patients with candidemia had higher survival rates.
Author(s): Wolfgruber S, Garcia-Vidal C, Sedik S, Salmanton-Garcia J, Arikan-Akdagli S, Gangneux J-P, Rautemaa-Richardson R, Arsic-Arsenijevic V, Martin-Perez S, Davila-Valls J, Erben N, Akalin EH, Drgona L, Lass-Florl C, Garcia-Rodriguez J, Bicanic T, Hammarstrom H, Hamal P, Steinmann J, Meijer EFJ, Khanna N, Desoubeaux G, Longval T, Sili U, Trauth J, Bassetti M, White PL, Aujayeb A, Matos T, Akyol D, Danion F, Lagrou K, Rogers B, Ruiz M, Sivakova A, Mikulska M, Samarkos M, Blennow O, Lockhart DEA, Denis B, Willinger B, van Dijk K, Scharmann U, Goodman AL, van Praet J, Narayanan M, Toscano C, Loughlin L, de Jonge NA, Ruiz-Gaitan A, Lanternier F, Prattes J, Roilides E, Talento AF, Barac A, Egger M, Arendrup MC, Koehler P, Cornely OA, Hoenigl M
Publication type: Article
Publication status: Published
Journal: Open Forum Infectious Diseases
Year: 2026
Volume: 13
Issue: 4
Online publication date: 26/03/2026
Acceptance date: 05/03/2026
Date deposited: 28/04/2026
ISSN (electronic): 2328-8957
Publisher: Oxford University Press
URL: https://doi.org/10.1093/ofid/ofag133
DOI: 10.1093/ofid/ofag133
Data Access Statement: Deidentified participant data at the case level, along with the data dictionary, will be available from the corresponding author (hoeniglmartin@gmail.com) upon request starting at the time of publica tion. Access will be granted following approval of study proposals by the ECMM Candida III steering committee, to ensure that planned analyses do not overlap with other ongoing or planned subanalyses of the dataset.
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