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case-control·infectious disease, pulmonology, critical care, epidemiology, internal medicine·PMC10052038

COVID-19 Is a Confounder of Increased Candida Airway Colonisation

Pathogens · 4 authors, 2 centres

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TL;DR

Independent associations were identified with mechanical ventilation, diabetes, length of hospitalisation, and antibacterial therapy.

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The study was a two-pronged, single-centre retrospective investigation at a French university hospital. It first documented a rise in respiratory samples and Candida-positive cultures concurrent with COVID-19 waves. Univariate analysis showed SARS-CoV-2 infection was more frequent in colonised patients, but multivariate analysis revealed it was a confounding factor, not independently significant. Independent risk factors for colonisation included mechanical ventilation, diabetes, length of hospitalisation, and antibacterial therapy, particularly carbapenems and cefepime. Colonisation was associated with a sevenfold increased risk of invasive fungal disease, especially fungaemia. The study is limited by its monocentric, retrospective design.

STUDY TYPE

case-control

SPECIALTY

infectious disease

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100% · A

ORIGINAL PAPER

PMC10052038

COVID-19 Is a Confounder of Increased Candida Airway Colonisation

Pathogens

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ABSTRACT

Abstract An increased incidence of invasive fungal infection was reported in SARS-CoV-2-infected patients hospitalised in the intensive care unit. However, the impact of COVID-19 on Candida airway colonisation has not yet been assessed. This study aimed to test the impact of several factors on Candida airway colonisation, including SARS-CoV-2 infection. We conducted a two-pronged monocentric retrospective study. First, we analysed the prevalence of positive yeast culture in respiratory samples obtained from 23 departments of the University Hospital of Marseille between 1 January 2018 and 31 March 2022. We then conducted a case-control study, comparing patients with documented Candida airway colonisation to two control groups. We observed an increase in the prevalence of yeast isolation over the study period. The case-control study included 300 patients. In the multivariate logistic regression, diabetes, mechanical ventilation, length of stay in the hospital, invasive fungal disease, and the use of antibacterials were independently associated with Candida airway colonisation. The association of SARS-CoV-2 infection with an increased risk of Candida airway colonisation is likely to be a consequence of confounding factors. Nevertheless, we found the length of stay in the hospital, mechanical ventilation, diabetes, and the use of antibacterials to be statistically significant independent risk factors of Candida airway colonisation. Keywords: Candida colonisation, Candida airway colonisation, SARS-CoV-2 infection, fungemia, risk factors, case-control study

CITATION EXPORT

Margaux Froidefond, Jacques Sevestre, Hervé Chaudet et al.. COVID-19 Is a Confounder of Increased Candida Airway Colonisation. Pathogens. (2023). https://doi.org/10.3390/pathogens12030463

AUTHORS

4 · 2 CENTRES

Margaux Froidefond, Jacques Sevestre, Hervé Chaudet, Stéphane Ranque

1Faculté des Sciences Médicales et Paramédicales, Aix Marseille University, IRD, AP-HM, SSA, VITROME, 13005 Marseille, France
2IHU Méditerranée Infection, 19-21 Boulevard Jean Moulin, 13005 Marseille, France