# Co-variation between blood stream infections with Candida species versus Pseudomonas aeruginosa, Staphylococcus aureus, and other isolates among 60 ICU patient cohorts

## TL;DR

This study examines how often blood stream infections caused by Candida species co-occur with bacterial infections in ICU patients.

## Contribution

The study quantifies the co-variation between Candida species and five bacterial pathogens in ICU blood stream infections.

## Key findings

- Candidemia showed the strongest co-variation with Acinetobacter species (correlation 0.69).
- Moderate co-variation was observed with Staphylococcus aureus (0.47) and Pseudomonas aeruginosa (0.4).
- Weaker co-variation was found with Coagulase-negative Staphylococci and Enterococcal species.

## Abstract

Staphylococcus aureus, Pseudomonas aeruginosa, Enterococcal species, Coagulase-negative Staphylococci, Acinetobacter species, and Candida species are common blood stream infection (BSI) isolates among intensive care unit (ICU) cohorts. That Candida species might interact with bacteria at mucosal surfaces to facilitate invasive infections prompts the question as to the degree of co-variance between Candida species versus bacteria among BSI isolates.

To estimate the co-variance between Candida species versus each of these five bacteria as BSI isolates among ICU patient cohorts.

The literature was searched opportunistically for studies reporting ICU patient cohorts listing Candida species among BSI isolates. The associations of the BSI incidence proportion per 100 patients were converted to logits and modelled using ellipse plots.

The median overall BSI incidence proportion was 7.8% (interquartile range; 4.8%–11.6%). Among 60 cohorts (50 publications), correlation with the incidence proportion of Candidemia was apparent for Acinetobacter species (correlation coefficient = 0.69), Staphylococcus aureus (0.47), and Pseudomonas aeruginosa (0.4) but less so for Coagulase-negative Staphylococci (0.37) and Enterococcal species (0.32).

There are various degrees of co-variance between the BSI incidence proportion amongst the five types of bacteria and Candida species among ICU cohorts.