Epidemiology, resistance patterns, and outcomes of candidemia acquired in Italian intensive care units: insights from the GIVITI network (2020–2024)
Authors' conclusion
ICU-acquired candidemia in Italy remains frequent and lethal, with a worrisome shift in epidemiology and resistance; the latter prolongs ICU stay without increasing mortality. Non-catheter-related episodes had a poorer prognosis.
Study context
- Population
- At-risk admissions (ICU LOS ≥ 48 h) to Italian ICUs95,662 at risk
- Participants
- 179,590 admissions
- Exposure
- ICU-acquired candidemia vs ICU-acquired bacterial bloodstream infection (BSI); fluconazole-resistant vs susceptible; non-catheter-related vs catheter-related
- Candidemian = 373
- Outcome
- Incidence of ICU-acquired candidemia per 1,000 at-risk ICU admissions (ICU LOS ≥ 48 h)
Methodological detailsPROSAFE network
- PROSAFE network
Main finding
As reported in the abstract
Incidence of ICU-acquired candidemia
Candidemia
3.9‰
373 of 373
Observational data: associations, not effects.
Further findings
ICU and hospital LOS, candidemia vs bacterial BSI
- ICU LOS, candidemia vs bacterial BSI
- 32 vs 24 days
- Hospital LOS, candidemia vs bacterial BSI
- 44 vs 36 days
- p < 0.001
Mortality, candidemia vs bacterial BSI
- Intra-ICU mortality, candidemia vs bacterial BSI
- 41.3% vs 28.7%
- Intra-hospital mortality, candidemia vs bacterial BSI
- 50.3% vs 34.1%
- p < 0.001
Species distribution
- Candida albicans
- 47.2%
- Candida parapsilosis
- 33.0%
- C. parapsilosis fluconazole-resistant
- 53.7%
Outcomes by fluconazole resistance
- ICU LOS, fluconazole-resistant vs susceptible
- 36 vs 31 days
- Mortality did not increase in fluconazole-resistant episodes
- p = 0.016
Intra-hospital mortality by source: non-catheter-related vs catheter-related
- Non-catheter-related infections
- 197/373, 52.8%
- Intra-hospital mortality, non-catheter-related vs catheter-related
- 57.0% vs 42.9%
- p = 0.007
Original publication
Epidemiology, resistance patterns, and outcomes of candidemia acquired in Italian intensive care units: insights from the GIVITI network (2020–2024). Crit Care. Published 8 April 2026. doi:10.
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