Insights into Candida Colonization in Intensive Care Unit Patients: A Prospective Multicenter Study

Teresa Nascimento, João Inácio, Daniela Guerreiro, Patrícia Patrício, Luís Proença, Cristina Toscano, Priscila Diaz, Helena Barroso, Arianna Tavanti (Editor)

Research output: Contribution to journalArticlepeer-review


The skin mycobiota plays a significant role in infection risk, pathogen transmission, and personalized medicine approaches in intensive care settings. This prospective multicenter study aimed to enhance our understanding of intensive care units’ (ICUs’) Candida colonization dynamics, identify modifiable risk factors, and assess their impact on survival risk. Specimens were taken from 675, 203, and 110 patients at the admission (D1), 5th (D5), and 8th (D8) days of ICU stay, respectively. The patient’s demographic and clinical data were collected. Candida isolates were identified by conventional culture-based microbiology combined with molecular approaches. Overall, colonization was 184/675 (27.3%), 87/203 (42.8%), and 58/110 (52.7%) on D1, D5, and D8, respectively. Candida colonization dynamics were significantly associated with ICU type (odds ratio (OR) = 2.03, 95% CI 1.22–3.39, p = 0.007), respiratory infection (OR = 1.74, 95% CI 1.17–2.58, p = 0.006), hemodialysis (OR = 2.19, 95% CI 1.17–4.10, p = 0.014), COVID-19 (OR = 0.37, 95% CI 0.14–0.99, p = 0.048), and with a poor 3-month outcome (p = 0.008). Skin Candida spp. colonization can be an early warning tool to generate valuable insights into the epidemiology, risk factors, and survival rates of critically ill patients, and should be considered for epidemiological surveillance.
Original languageEnglish
Number of pages13
JournalJournal of Fungi
Issue number6
Publication statusPublished - 25 May 2024


  • surveillance
  • Candida spp.
  • risk factors
  • intensive care unit
  • prevalence
  • colonization


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