Patterns and Predictors of Candidemia with Multidrug-Resistant Bacterial Co-Infections: Results from the CANDI-MDR Study.

INTRODUCTION

(now ) and multidrug-resistant (MDR) bacterial infections pose significant therapeutic challenges due to high antimicrobial resistance, increased mortality, and persistence in healthcare settings. In Greece, their rising prevalence is raising concerns regarding co-infection, yet comprehensive data remain limited. This study aims to investigate the epidemiology, risk factors, and clinical outcomes of MDR bacterial co-infection in patients with candidemia.

METHODS

This single-center, retrospective observational cohort study was conducted at a Greek tertiary university hospital and included adult patients with bloodstream infections from January 2019 to June 2024. The data were analyzed using appropriate statistical methodologies.

RESULTS

Among 96 patients, those with candidemia and MDR bacterial co-infection exhibited a significantly higher mortality rate (87.23% vs. 61.22%, = 0.007). The presence of a central venous catheter was the only factor significantly associated with MDR co-infection ( = 0.030). In univariate analysis, MDR co-infection, a higher Charlson Comorbidity Index, and mechanical ventilation correlated with increased mortality. Multivariate analysis identified MDR co-infection (OR = 3.19, = 0.045) and mechanical ventilation (OR = 7.07, = 0.002) as independent mortality predictors.

CONCLUSIONS

These findings underscore the need for enhanced surveillance, precise identification, and stringent infection control measures to prevent and MDR bacterial outbreaks in healthcare settings.