Epidemiology, management and outcome of candidaemia in patients with diabetes

J R Coll Physicians Edinb. 2022 Dec;52(4):292-297. doi: 10.1177/14782715221137451. Epub 2022 Nov 24.

Abstract

Background: Candidaemia is the commonest fungal bloodstream infection in hospitalised patients. Diabetes is one of the risk factors for mortality from candidaemia.

Methods: We compared the epidemiology, clinical characteristics and management of candidaemia in patients with and without diabetes.

Results: Over a 10-year period, 200 episodes of Candida bloodstream infection were documented. Patients with diabetes were younger (58.7 vs 65.5 years), less likely to be suffering from cancer (21.8% vs 36%), and had significantly lower 30-day and 90-day crude mortality (17.2% vs 35.6% and 28.4% vs 48.6%, respectively). Candida glabrata was more common in patients with diabetes (39.3% vs 29.7%). Based on European Confederation of Medical Mycology (ECMM) quality indicators, the management of patients with and without diabetes was similar.

Discussion: Our study highlights the importance of epidemiological data in relation to candidaemia in patients with diabetes and the growing threat of invasive C. glabrata infection in this subset of patients.

Keywords: Candida glabrata; candidaemia; diabetes; fluconazole; fundoscopy; quality indicators.

MeSH terms

  • Antifungal Agents / therapeutic use
  • Candida
  • Candidemia* / drug therapy
  • Candidemia* / epidemiology
  • Candidemia* / microbiology
  • Candidiasis* / epidemiology
  • Candidiasis* / microbiology
  • Diabetes Mellitus* / drug therapy
  • Diabetes Mellitus* / epidemiology
  • Humans
  • Microbial Sensitivity Tests

Substances

  • Antifungal Agents