# Characterization of COVID‐19‐Associated Candidemia Among Burn Patients

## TL;DR

This study examines fungal infections in burn patients with COVID-19, finding high mortality and drug resistance in Candida species.

## Contribution

The study identifies key risk factors and antifungal resistance patterns in Candida infections among ICU burn patients with concurrent COVID-19.

## Key findings

- Candida parapsilosis was the most common species in ICU burn patients with concurrent COVID-19.
- Mortality rates were higher in infected patients (69.0%) compared to colonized patients (43.8%).
- Luliconazole and amphotericin B showed the highest effectiveness against Candida isolates.

## Abstract

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.

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.

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.

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.

This study investigates the distribution of Candida species isolated from burn patients with candidemia, colonization, and urinary cultures. The findings highlight the predominance of
C. albicans
and
C. parapsilosis
across different sample types, including wound colonization, blood, and urine. Furthermore, species distribution was analyzed by body regions, providing valuable insights into the prevalence and anatomical patterns of fungal infections in burn patients. These results underscore the importance of targeted diagnostic and therapeutic approaches in managing fungal infections in this vulnerable population.