Candidemia in Turkey demonstrates nationwide predominance of non-albicans Candida and Candida auris detection

Abstract

In recent years, evolving patterns in candidemia epidemiology, including increasing proportions of non-albicans Candida (NAC) species and the emergence of Candida auris , have been reported. We aimed to characterize contemporary candidemia epidemiology in Turkey and to assess the association between guideline adherence and 30-day mortality. In this nationwide retrospective multicenter cohort study, adult patients with blood culture–confirmed candidemia diagnosed between January 2022 and December 2023 in 20 hospitals were included. Species identification was standardized and confirmed using MALDI-TOF MS. A total of 398 candidemia episodes were analyzed. Although Candida albicans remained the single most common species (34.7%), NAC species predominated overall (65.3%), mainly driven by Candida parapsilosis (26.6%), while C. auris accounted for 6.5% of cases and was detected across multiple centers. Crude mortality was 68.3% and 30-day mortality was 56.3%. Failure to remove central venous catheters (CVC) was independently associated with higher 30-day mortality. Kaplan–Meier analysis demonstrated significant differences in 30-day survival across EQUAL Candida score categories in the overall candidemia cohort (log-rank p = 0.02) and among patients with CVC-related candidemia cohort (log-rank p = 0.008). Collectively, our findings provide a contemporary nationwide overview of candidemia in Turkey, highlighting the predominance of NAC species, the multicenter detection of C. auris , and the clinical importance of early source control.