P-1943. Outcome of invasive Candida infections in Europe and the US: Results from an ongoing multinational study [2024-2026]

TL;DR

This study examines the outcomes of invasive Candida infections in Europe and the US, highlighting risk factors, treatments, and a high mortality rate of 39.4%.

Contribution

The study provides a multinational analysis of invasive Candida infections, revealing treatment patterns and outcomes across different regions.

Findings

Echinocandins were the most common first-line treatment, with fluconazole used for second-line therapy.

Neither initial antifungal choice nor Candida species significantly impacted survival.

The overall mortality rate was 39.4%, emphasizing the need for improved management strategies.

Abstract

Invasive Candida infection cause significant morbidity and mortality, especially in immunocompromised patients. The FungiScope Candida Campaign 2024–2026 aims to analyze clinical data to better understand risk factors, treatments, and outcomes in this population across different geographical regions.

Anonymized patient data were collected via an online questionnaire (www.clinicalsurveys.net for Europe, Carelane for the USA), capturing demographics, clinical history, diagnostic findings, antifungal treatment, source control measures, and patient outcomes.

A total of 463 patients with invasive Candida infection were included by April 2025, with a median age of 67 years (range: 18–102); 62.2% were male. Most cases were reported from Germany (n=213; 46.0%), followed by Spain (171; 36.9%) and Italy (39; 8.4%).

Frequent risk factors included central venous catheter use (54.6%), ICU treatment (42.8%), chronic cardiovascular disease (40.6%), hematological/oncological conditions (38.7%), and recent major surgery (35.9%). Chronic kidney diseases/acute kidney injury and uncontrolled diabetes were present in 22.9% and 22.5% of cases, respectively.

Most patients received antifungal therapy (92%; median 14 days, range 1–306). First-line agents included caspofungin (43.6%), anidulafungin (23.7%), and fluconazole (21.1%), while fluconazole (47.3%) and caspofungin (18.5%) predominated as second-line treatment.

Germany predominantly used caspofungin (75.1%), whereas Spain favored anidulafungin (51.2%) as the first-line agent. In Italy, fluconazole (35.9%) and caspofungin (33.3%) were the leading choices. Survival was not significantly influenced by either the initial antifungal therapy (χ²(9) = 13.76, p = 0.131) or the Candida species (albicans vs. non-albicans; χ²(1) = 0.54, p = 0.462).Overall mortality was 39.4%.

In this multinational cohort, echinocandins were predominantly used as first-line treatment and fluconazole for second-line. Neither initial antifungal choice nor Candida species (albicans vs. non-albicans) significantly impacted survival, highlighting the urgent need for optimized management strategies to reduce high mortality rates.

Jon Salmanton-Garcia, MSc, MPH, PhD, menarini, gilead, astrazeneca, pfizer: Honoraria Rosanne Sprute, Dr., Hikma: Honoraria|Mundipharma: Honoraria|Pfizer: Honoraria Oliver A. Cornely, Prof. Dr., Al-Jazeera Pharmaceuticals/Hikma: Honoraria|Basilea: Advisor/Consultant|Cidara: Advisor/Consultant|Cidara: Board Member|Cidara: Grant/Research Support|Elion: Advisor/Consultant|F2G: Grant/Research Support|Gilead: Advisor/Consultant|Gilead: Grant/Research Support|Gilead: Honoraria|GlaxoSmithKline: Advisor/Consultant|GlaxoSmithKline: Honoraria|Grupo Biotoscana/United Medical/Knight: Honoraria|Melinta: Advisor/Consultant|Melinta: Board Member|MSD: Honoraria|Mundipharma: Advisor/Consultant|Mundipharma: Grant/Research Support|Mundipharma: Honoraria|Pfizer: Advisor/Consultant|Pfizer: Grant/Research Support|Pfizer: Honoraria|Pulmocide: Board Member|Scynexis: Advisor/Consultant|Scynexis: Grant/Research Support|Shionogi: Advisor/Consultant|Shionogi: Honoraria