Characterization of COVID-19-Associated Candidemia Among Burn Patients

J Clin Lab Anal. 2025 May;39(10):e70031. doi: 10.1002/jcla.70031. Epub 2025 Apr 8.

Abstract

Background: The emergence of COVID-19 has led to a significant public health crisis, and an increase in fungal infections, including candidemia. Candida species are frequently found in intensive care units (ICUs), and it is a common cause of death in many patients. The isolates were identified using polymerase chain reaction-restriction. In this study, We investigated the factors linked to Candida infections in COVID-19 burn patients in the ICU and assessed the antifungal susceptibility of the isolates in vitro.

Methods: Out of 335 burn patients admitted to the ICU, fifty-six with concurrent COVID-19 were included in this study. A total of 133 yeast isolates were obtained from burn wounds, 29 from blood cultures, and 36 from urine cultures. The isolates were identified using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis.

Results: Out of fifty-six patients, twenty-nine had infections and forty-eight had colonization, with Candida parapsilosis being the most common species. Twenty-one patients died during their ICU stay, with mortality rates of 43.8% among colonized patients and 69.0% among infected patients. Fluconazole and itraconazole exhibited the highest minimum inhibitory concentrations, while luliconazole and amphotericin B were identified as the most effective antifungal agents.

Conclusion: Our findings indicate that colonization may act as an important prognostic factor prior to the onset of candidemia. In addition, prolonged hospitalization, catheter use, and concurrent COVID-19 infection were identified as key risk factors for candidemia in this patient group. Notably, the rising drug resistance in non-albicans Candida species is a major public health concern.

Keywords: COVID‐19; Candidemia; burn patients; fungal infection; wound colonization.

MeSH terms

  • Adult
  • Aged
  • Antifungal Agents / pharmacology
  • Antifungal Agents / therapeutic use
  • Burns* / complications
  • Burns* / microbiology
  • COVID-19* / complications
  • Candida / drug effects
  • Candida / isolation & purification
  • Candidemia* / complications
  • Candidemia* / drug therapy
  • Candidemia* / epidemiology
  • Candidemia* / microbiology
  • Candidemia* / mortality
  • Female
  • Humans
  • Intensive Care Units
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • SARS-CoV-2

Substances

  • Antifungal Agents