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Volume 14
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10.3390/antibiotics14050452
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Article

The Influence of the Seasonal Variability of Candida spp. Bloodstream Infections and Antifungal Treatment: A Mediterranean Pilot Study

by
Paola Di Carlo
1,
Nicola Serra
2,*,
Ornella Collotta
3,
Claudia Colomba
1,
Alberto Firenze
1,
Luigi Aprea
4,
Salvatore Antonino Distefano
4,
Andrea Cortegiani
5,
Giovanni Giammanco
1,
Teresa Maria Assunta Fasciana
1,
Roberta Virruso
4,
Angela Capuano
6,
Consolato M. Sergi
7,8 and
Antonio Cascio
1
1
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy
2
Department of Neuroscience, Reproductive Sciences and Dentistry Department, Audiology Section “Federico II” University of Naples Federico II, 80131 Naples, Italy
3
Degree Course in Medicine and Surgery, Medical School of Hypatia, University of Palermo, 93100 Caltanissetta, Italy
4
Azienda Ospedaliera Universitaria Policlinico “Paolo Giaccone”, 90127 Palermo, Italy
5
Department of Precision Medicine in Medical, Surgical and Critical Care Area (Me.Pre.C.C.), University of Palermo, 90127 Palermo, Italy
6
Department of Emergency, AORN Santobono-Pausilipon, 80122 Naples, Italy
7
Anatomic Pathology Division, Children’s Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON K1H 8M5, Canada
8
Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB T6G 2R3, Canada
*
Author to whom correspondence should be addressed.
Antibiotics 2025, 14(5), 452; https://doi.org/10.3390/antibiotics14050452
Submission received: 3 April 2025 / Revised: 23 April 2025 / Accepted: 28 April 2025 / Published: 29 April 2025
(This article belongs to the Special Issue Climate Change and Antibiotic Resistance)
Review Reports Versions Notes

Abstract

Background/Objectives: Various factors associated with seasonality, including temperature, humidity, geographical composition, and seasonal fluctuations, can influence the trends of microbes responsible for hospital infections, such as Candida spp. This study evaluates the seasonal variability of Candida spp. bloodstream infections and antifungal resistance in hospitalized patients in Sicily. Methods: We retrospectively analyzed the demographic and epidemiological characteristics of 175 patients with blood cultures positive for Candida spp. Who were hospitalized at University Hospital Paolo Giaccone (A.U.O.P.), University of Palermo, Italy, from 1 January 2022 to 31 December 2024. Data on Candida species and antifungal resistance were also collected from the hospital’s database system to prevent and control hospital infections in A.U.O.P. Results: A total of 175 patients, 57.7% males, with a mean age of 68.3 years, were included in this study. Candida parapsilosis, Candida albicans, and Candida glabrata were more frequent in ICU (54.5%, p = 0.0001), medical (72.5%, p = 0.0003), and surgical settings (24%, p = 0.0161), respectively. C. parapsilosis was more frequent in dead patients (53.2%, p = 0.005). Among the seasons, we observed a significantly higher presence of C. glabrata in Autumn (20%, p = 0.0436). From the analysis of the seasons, C. parapsilosis and C. albicans were more frequent for each season, except in Spring, where the most frequent isolates were C. glabrata (5.1%, p = 0.0237) and C. parapsilosis (9.7%, p < 0.0001). The antifungal with the most resistance to Candida spp. was fluconazole in all seasons. Conclusions: Our study highlights the seasonal trends in Candida spp. and antifungal resistance, emphasizing climate change’s challenges on fungal diseases. These findings may contribute to improving prevention and treatment strategies for candidemia.
Keywords: seasonality; candidemia; survey; antifungal; Candida parapsilosis; Candida glabrata; Candida albicans; fluconazole seasonality; candidemia; survey; antifungal; Candida parapsilosis; Candida glabrata; Candida albicans; fluconazole

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MDPI and ACS Style

Di Carlo, P.; Serra, N.; Collotta, O.; Colomba, C.; Firenze, A.; Aprea, L.; Distefano, S.A.; Cortegiani, A.; Giammanco, G.; Fasciana, T.M.A.; et al. The Influence of the Seasonal Variability of Candida spp. Bloodstream Infections and Antifungal Treatment: A Mediterranean Pilot Study. Antibiotics 2025, 14, 452. https://doi.org/10.3390/antibiotics14050452

AMA Style

Di Carlo P, Serra N, Collotta O, Colomba C, Firenze A, Aprea L, Distefano SA, Cortegiani A, Giammanco G, Fasciana TMA, et al. The Influence of the Seasonal Variability of Candida spp. Bloodstream Infections and Antifungal Treatment: A Mediterranean Pilot Study. Antibiotics. 2025; 14(5):452. https://doi.org/10.3390/antibiotics14050452

Chicago/Turabian Style

Di Carlo, Paola, Nicola Serra, Ornella Collotta, Claudia Colomba, Alberto Firenze, Luigi Aprea, Salvatore Antonino Distefano, Andrea Cortegiani, Giovanni Giammanco, Teresa Maria Assunta Fasciana, and et al. 2025. "The Influence of the Seasonal Variability of Candida spp. Bloodstream Infections and Antifungal Treatment: A Mediterranean Pilot Study" Antibiotics 14, no. 5: 452. https://doi.org/10.3390/antibiotics14050452

APA Style

Di Carlo, P., Serra, N., Collotta, O., Colomba, C., Firenze, A., Aprea, L., Distefano, S. A., Cortegiani, A., Giammanco, G., Fasciana, T. M. A., Virruso, R., Capuano, A., Sergi, C. M., & Cascio, A. (2025). The Influence of the Seasonal Variability of Candida spp. Bloodstream Infections and Antifungal Treatment: A Mediterranean Pilot Study. Antibiotics, 14(5), 452. https://doi.org/10.3390/antibiotics14050452

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