Search Results (1,290)

In the literature, there is a limited number of case reports of Paenibacillus urinalis in adults. However, there is no information available regarding P. urinalis infection in children and infants. Paenibacillus growth in blood and sterile site cultures is generally considered contamination; it is unclear whether P. urinalis is the true cause of the infection. In this retrospective study, we aimed to clinically evaluate P. urinalis growth in the blood cultures of children at a tertiary referral hospital over a 5.5-year period, with identification performed using the MALDI-TOF MS method. A total of 170 hospitalized children showed P. urinalis growth in sterile site cultures (blood: 162; catheter: 7; CSF: 1), with forty percent of all growth occurring in only three wards (neonatal intensive care unit, hematology, oncology). Of 170 cultures, 5 (2.9%) showed further P. urinalis growth in control cultures, which could be considered significant. In cases with a second culture, the average growth time (time to positivity) was relatively short, at 24 + 7 h (mean + SD, min-max: 17–33 h). No mortality was observed in any case. Evaluations were conducted by the Hospital Infection Control Committee to determine the source of P. urinalis contamination. P. urinalis growth was detected in 33% of samples taken from clean, packaged linens before use; 53% of ambient air cultures; and 65% of hospitalized patient skin swabs. In conclusion, P. urinalis blood culture growths are primarily considered contamination; however, these growths should be carefully evaluated in risk groups (especially those admitted in neonatal intensive care units and young infants less than 3 months old). In hospitalized patients, clustered growths may be influenced by environmental (such as clean packaged linens and ambient air) and skin colonization. Full article

Built and ambient features of hospital ward design may influence patient safety and inform future hospital construction and refurbishment. However, evidence on their overall impact remains fragmented. This review synthesised available evidence and highlighted key differences from previous reviews. A comprehensive search identified studies published between 1993 and 2023 involving hospital inpatients. Data were extracted from eligible systematic reviews and subsequently from cited primary studies to synthesise findings and address inconsistencies. Meta-analyses and effect size calculations were performed where appropriate. A total of 31 reviews and 50 primary studies were included. Fall outcomes mainly involved geriatric patients, while infection and delirium outcomes were derived from mixed adult populations. Compared with multi-bedrooms, single-patient rooms were associated with increased fall rates and numbers of fallers, but a lower proportion of patients and rates of hospital-acquired infection and delirium. Natural light and vinyl flooring showed non-significant trends toward reduced delirium and fewer fallers, respectively. Vinyl flooring was associated with higher injurious fall rates. Certainty of evidence was low to very low. Hospital ward design may substantially affect patient safety and quality of care, particularly for older adults. However, effects may be favourable or unfavourable depending on the outcome considered. Further empirical and economic research is needed to balance these competing outcomes. Full article

Background/Objectives: This study examined the impact of data pre-processing on indirectly derived reference intervals for intact parathyroid hormone (iPTH). Routine laboratory data from a single Norwegian site, measured on the Abbott Alinity i analyzer, were processed with different pre-processing steps before applying and comparing three indirect estimation methods. Methods: Data pre-processing consisted of several steps, including filtering based on the number of results per patient, exclusion of specific hospital wards, and the use of predefined biomarkers. Reference intervals were estimated for datasets subjected to different pre-processing strategies using three indirect methods: RefLim, truncated maximum likelihood (TML), and refineR. The impact of pre-processing on the derived reference intervals was systematically evaluated. In addition, vitamin D status and estimated glomerular filtration rate (eGFR) were evaluated as potential partitioning criteria. For comparison, reference intervals were also calculated using both conventional parametric and nonparametric estimation methods. Results: Data pre-processing had a pronounced impact on the estimated reference intervals. Restricting the dataset to subjects with a single measurement proved to be an effective strategy for excluding pathological patients, whereas exclusion of specific hospital wards and biomarker-based filtering had a negligible additional effect. Conclusions: While stringent data pre-processing and large initial datasets are essential for reliable indirect reference interval estimation of complex analytes such as iPTH, the choice of pre-processing strategy must be guided by analyte-specific characteristics, as different analytes may require different approaches. Full article

Background/Objectives: Stenotrophomonas maltophilia is a critical opportunistic pathogen, yet its long-term epidemiology remains underrepresented in global surveillance frameworks like WHO GLASS. We aimed to analyze its six-year epidemiological trend in a large Polish tertiary hospital. Methods: A retrospective study (2020–2025) of 399 non-duplicate isolates was conducted. Identification was performed using MALDI-TOF MS, and susceptibility was analyzed according to EUCAST breakpoints. Antibiotic consumption (DDD/100 patient-days) was correlated with isolation trends. Results: Wound/skin (36.8%) and lower respiratory tract (35.8%) samples predominated. A significant rise in respiratory isolates was observed post-2020, coinciding with peak carbapenem consumption in ICU and surgical wards. Ward-level analysis demonstrated that intensive care unit status (β = 68.9, 95% CI 46.1–91.8, p < 0.001) and carbapenem consumption (β = 0.080, 95% CI 0.004–0.156, p = 0.041) were independently associated with S. maltophilia isolation burden after adjustment for ward type (adjusted R² = 0.80). While trimethoprim–sulfamethoxazole remained highly active, levofloxacin susceptibility showed high interannual variability. Conclusions: S. maltophilia is a stable and clinically significant threat in high-intensity hospital environments. Our findings support the inclusion of this pathogen in international AMR monitoring (GLASS) and emphasize strict carbapenem stewardship to curb its emergence. Full article

The association of atrial fibrillation (AF) and neck of femur fractures (NOF) are common in old people, creating a complex clinical scenario with significant implications for morbidity, mortality, and healthcare systems. This narrative review explores the bidirectional relationship between AF and NOF, focusing on shared risk factors, pathophysiological links, and challenges in clinical management, and also reviews the benefit of an orthogeriatric model. Advanced age, frailty, osteoporosis, polypharmacy, and cardiovascular comorbidities predispose patients to both conditions, while AF itself increases fall risk through haemodynamic instability, syncope, and adverse effects of rate- or rhythm-controlling medications. Importantly, the physiological stress of hip fracture and subsequent surgery can precipitate new-onset or worsening AF via inflammatory, neurohormonal, and metabolic mechanisms. The main challenge for ortho-geriatricians lies in anticoagulation management and preoperative and postoperative management. While anticoagulation reduces thromboembolic risk in AF, it increases perioperative bleeding risk in patients with NOF, often leading to delays in surgery that are independently associated with poorer outcomes. This review examines the current evidence regarding perioperative anticoagulation strategies, timing of surgery, and postoperative resumption of therapy. In addition, the review examines important outcome parameters such as mortality, stroke, bleeding, length of hospital stay, and functional recovery. This highlights the importance of not only improving multidisciplinary care involving orthopaedics, cardiology, geriatrics, and anaesthesia to optimise outcomes, but also enhancing risk stratification. Standardised perioperative pathways and integrated geriatric–cardiac assessment may help mitigate complications. Therefore, understanding how AF and NOF interact is key to delivering holistic, patient-centred care for an increasingly elderly population in orthogeriatric wards. Full article

Background: Post-anesthesia care unit (PACU) duration after total hip arthroplasty (THA) is relevant for ward transfer, early mobilization, and perioperative flow, but is inconsistently reported as a distinct recovery outcome. This study evaluated PACU duration after primary THA under spinal anesthesia in routine hospital-based practice and interpreted the observed duration in relation to contemporary arthroplasty literature. Methods: This retrospective observational cohort study included adult patients undergoing primary THA under spinal anesthesia within two units of a regional hospital. PACU duration was defined as time from PACU arrival until discharge to the orthopedic ward. Demographic, anesthetic, perioperative, and recovery variables were extracted from electronic medical records. Univariate analyses and multivariable linear regression were used to explore factors associated with PACU duration. A focused contextual literature comparison was performed to interpret the observed duration in relation to reported early recovery endpoints, with direct comparison anchored to conventional PACU or recovery-room intervals before ward transfer or immediate pathway progression. Results: Ninety-seven of 150 screened patients were included. Mean PACU duration was 162.3 ± 58.5 min. PACU duration was numerically longer in Unit A than Unit S, but the difference was not statistically significant. Reported early recovery endpoints in the literature were heterogeneous. In univariate analysis, male sex and exploratory spinal local anesthetic dose > 13 mg were associated with longer PACU duration. In multivariable analysis, male sex remained associated with longer PACU duration, whereas spinal dose was not independently associated when analyzed as a continuous variable. Conclusions: PACU duration after THA under spinal anesthesia should be interpreted as a multifactorial, workflow-sensitive outcome rather than a purely anesthetic recovery measure. Differences in discharge criteria, recovery pathways, and endpoint definitions limit direct comparison across studies. PACU duration may be most meaningful as an operational recovery and flow indicator within broadly comparable clinical settings. Full article

This study, based on the WELL Health Building Standard as the theoretical framework, combined with case analyses of 38 geriatric care hospital wards in South Korea and multi-group questionnaires (60 responses each from the medical service, design field, and elderly population groups), systematically explored the design elements and their importance cognition of healing environments in hospital rooms. Through cross-comparison analysis, quantitative (SPSS 25.0 multiple regressions, correlation analysis) and qualitative (ATLAS.ti 9 coding) data fusion methods, the study proposed four core design principles centered on “Beauty and Design,” “Nature Connectedness,” “Privacy,” and “Community and Information” and selected 36 key assessment indicators. The data analysis indicated that the perceived importance of the elderly population (AX) had the greatest impact on the compliance rate of rooms (AR) (β = 0.506, p = 0.002) and the medical staff group (AT) paid more attention to functional design (β = 0.506, p = 0.005), while the designer group (AV) emphasized aesthetic innovation and natural light planning (β = 0.367, p = 0.28). The study further proposed a hierarchical optimization strategy, emphasizing the balanced design of functional requirements, aesthetic innovation, and patient experience through cross-group collaborative design mechanisms. The research results provide theoretical and practical guidance for the healing environmental optimization of hospital rooms in elderly care hospitals. Full article

Background/Objectives: Illness uncertainty is a pervasive psychosocial experience in chronic conditions that is particularly prominent in pediatric oncology. While existing research has explored its psychological impact, a gap remains in understanding how this uncertainty evolves throughout the disease trajectory and how families collectively negotiate and manage this experience over the long term. Methods: This qualitative study was conducted in the hematology ward at a pediatric hospital in Shanghai, China. Using purposive sampling, semi-structured interviews were performed with 32 participants from 12 families of children currently undergoing cancer treatment. Data were collected through in-depth interviews and analyzed using reflexive thematic analysis. The sample was dominated by leukemia cases, with a small number of lymphoma cases; therefore, the findings are most directly transferable to families of children with hematological malignancies. Results: Illness uncertainty is a dynamic and persistent experience permeating the entire pediatric cancer trajectory. Key sources of uncertainty include diagnostic ambiguity and delays, barriers in physician–patient communication, and profound disruptions to family daily life. In response, families proactively develop multidimensional coping strategies: reframing meaning to accept uncertainty, reorganizing family roles and responsibilities, strengthening internal communication, and mobilizing external support networks. These strategies demonstrate both family resilience and inherent vulnerability under sustained pressure. Conclusions: Illness uncertainty in pediatric cancer transcends medical boundaries and is deeply embedded in family life. Healthcare systems should recognize uncertainty as a core experience throughout the disease process and provide family-centered psychosocial and structural support. Strengthening hospital social work services and fostering synergy between peer networks and community resources are essential to enhancing families’ capacity to manage uncertainty and alleviating their long-term psychosocial burden. Full article

Background and Objectives: West Nile virus (WNV) infection has a broad clinical spectrum ranging from asymptomatic or mild disease to severe neuroinvasive forms. Data on hospitalized patients with atypical or non-neurological presentations remain limited. Materials and Methods: We conducted a retrospective multicenter observational study including 30 patients with laboratory-confirmed WNV infection admitted to internal medicine wards during a seasonal outbreak in Southern Italy. Clinical characteristics, hematological parameters, and in-hospital outcomes were analyzed. Results: Median age was 77 years, and 53% of patients were male. Neurological involvement was observed in 50% of patients, whereas 37% presented with septic-like manifestations. Overall in-hospital mortality was 43%, and early mortality within 10 days occurred in 17%. Neurological involvement was significantly more frequent among non-survivors and was associated with increased in-hospital mortality. Higher monocyte percentages were associated with overall mortality, whereas eosinopenia, leukopenia, and thrombocytopenia were associated with early mortality in exploratory analyses. Conclusions: Hospitalized patients with WNV infection may present with heterogeneous clinical phenotypes extending beyond classical neuroinvasive disease. Neurological involvement appears to be the main clinical marker of adverse outcome, while selected hematological parameters may provide preliminary prognostic information. Given the limited sample size and retrospective design, these findings should be considered hypothesis-generating. Full article

Background/Objectives: Clostridioides difficile infection (CDI) is an increasingly recognised nosocomial complication in patients hospitalised with coronavirus disease 2019 (COVID-19), driven by broad-spectrum antibiotic exposure, corticosteroid use, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related intestinal dysbiosis. The contribution of underlying cardiovascular comorbidities, particularly heart failure, to CDI susceptibility in hospitalised COVID-19 patients remains insufficiently characterised. We aimed to evaluate the prevalence, risk factors, and clinical impact of CDI in hospitalised COVID-19 patients at a tertiary Romanian infectious diseases centre, with a specific focus on cardiovascular disease and modifiable antimicrobial-prescribing factors. Methods: This single-centre retrospective observational cohort study enrolled 395 consecutive adult patients hospitalised with SARS-CoV-2 infection confirmed by reverse transcription polymerase chain reaction (RT-PCR) at the “Victor Babeș” Clinical Hospital for Infectious Diseases and Pneumophthisiology, Timișoara, Romania, between 1 March 2020 and 31 December 2024. Patients were stratified into a CDI group (n = 24) and a non-CDI group (n = 371) on the basis of hospital-onset CDI. Demographic, clinical, laboratory, therapeutic, and outcome variables were extracted from electronic medical records. Continuous variables were compared using Student’s independent-samples t-test, categorical variables using Fisher’s exact test; odds ratios (ORs) with exact 95% confidence intervals (CIs) were computed for all binary comparisons, and a parsimonious multivariable logistic regression was used to adjust the antibiotic-exposure effect for age. Temporal relationships between CDI onset and sepsis documentation were also analysed. A two-sided p-value < 0.05 was considered statistically significant. Results: CDI was identified in 24 patients (prevalence 6.1%). The CDI and non-CDI groups were comparable in age (71.1 ± 10.2 vs. 71.7 ± 11.4 years; p = 0.817), sex distribution (50.0% vs. 45.8% female; p = 0.833), and vaccination status (p = 0.383). Heart failure prevalence did not differ between groups (29.2% vs. 26.7%; OR 1.13, 95% CI 0.46–2.81; p = 0.813). Any antibiotic therapy was strongly associated with CDI (95.8% vs. 70.6%; OR 9.57, 95% CI 1.28–71.74; p = 0.004), as was longer duration of antibiotic therapy (8.1 ± 2.2 vs. 5.2 ± 3.7 days; p < 0.001). In the multivariable model, each additional day of antibiotic therapy was independently associated with a 13.6% increase in the odds of CDI (adjusted OR 1.14 per day, 95% CI 1.03–1.26; p = 0.013) after adjustment for age. Piperacillin/tazobactam accounted for 65.2% (15/23) of the recorded pre-CDI broad-spectrum antibiotic regimens among antibiotic-exposed CDI patients. Documented sepsis was substantially more frequent in CDI patients (95.8% vs. 15.4%; p < 0.001) and length of hospitalisation was prolonged (15.6 ± 8.2 vs. 12.0 ± 8.1 days; p = 0.038). In-hospital mortality did not differ significantly (4.2% vs. 7.5%; p = 1.000). Conclusions: Hospital-onset CDI complicated 6.1% of hospitalised COVID-19 admissions and was independently associated with the cumulative duration of antibiotic therapy. Heart failure was not significantly associated with CDI in this cohort; however, given the limited number of CDI events, this should be interpreted as absence of evidence rather than evidence of absence. CDI was also associated with prolonged hospitalisation and high co-occurrence of documented sepsis, although causality cannot be inferred from the retrospective design. These findings support strengthened antibiotic stewardship and targeted CDI surveillance in COVID-19 inpatient wards. Full article

Background: The illegal status of recreational cannabis (RC) is often considered a barrier to its use. RC was partially legalized in Germany in 2024. This study investigated whether attitudes towards cannabis were different in patients surveyed after recreational cannabis legalization (RCL), compared with patients surveyed before RCL. Method: In 2022 (pre-RCL) and 2024/2025 (post-RCL), patients without psychosis and without substance use disorders from in-patient and day clinic wards of a psychiatric university hospital were interviewed using a standardized questionnaire. Results: Included were n = 143 patients pre-RCL and n = 117 post-RCL, with 84% presenting with affective disorders. Only 11.2% in the pre-RCL group, and 1.7% in the post-RCL group indicated the illegal status of RC as the main reason for cannabis abstinence. Attitudes towards cannabis with regard to health concerns, social distance, general rejection of (illicit) drugs, effects of drug education, or observation of negative consequences in others were not statistically significantly different between groups. There was a marked and statistically significant reduction in fear of being investigated by the police because of RC consumption. The suggestion to buy cannabis for personal use in specialized shops was completely rejected by 58.7% of the pre-RCL and by 71.8% of the post-RCL group. Conclusions: Compared with pre-RCL data, concerns about negative legal consequences of RC use were lower during the first year post-RCL, but readiness to legally obtain recreational cannabis was not increased. There were no indications that other attitudes about cannabis were affected in the short term. Full article

Background: Sarcopenia, characterized by age-related loss of muscle mass and strength, is a growing public health concern requiring early detection; this exploratory study evaluated a range of anthropometric measurements and indices to identify those most suitable for screening low muscle strength in hospitalized geriatric patients and to determine preliminary cut-off values that may support screening in settings with limited access to specialized equipment or trained personnel. Materials and Methods: In this cross-sectional study, 390 hospitalized geriatric-ward patients aged ≥ 60 years were included. The median age was 77.00 years (72.00, 82.00), and 258 participants (66.2%) were women. Anthropometric and body composition measurements were performed, and handgrip strength was assessed. Low muscle strength was defined according to The European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria. Logistic regression analyses were used to assess associations between anthropometric measurements and low muscle strength, and receiver operating characteristic (ROC) curve analysis was used to evaluate their screening performance. Results: Among 390 participants, 67 (17.2%) had low muscle strength. Low muscle strength was associated with older age, lower body weight, BMI (Body Mass Index), fat-free mass, and smaller arm and calf circumferences. Higher arm and calf circumferences were significantly associated with a lower risk of low muscle strength in both women (OR = 0.913 and 0.884) and men (OR = 0.793 and 0.769; all p < 0.05). ROC analysis identified optimal screening cut-offs: arm 26.5 cm and calf 31.5 cm in women, and arm 29.5 cm and calf 33 cm in men, showing moderate screening performance, with an area under the ROC curve (AUC) of 0.63–0.78. Conclusions: Calf and arm circumferences are simple, quick, and non-invasive measurements that may be useful for screening low muscle strength in hospitalized geriatric patients, particularly in settings with limited access to specialized equipment. These measurements may help identify individuals who require further assessment for sarcopenia according to current clinical guidelines, with age being an important factor to consider. The proposed cut-off values should be considered hypothesis-generating rather than diagnostic thresholds for sarcopenia and require external validation in independent populations before they can be recommended for routine clinical use. Full article

Background/Objectives: The acute complications of COVID-19 have been well characterized and are frequently associated with increased mortality. Although substantial knowledge regarding long COVID has accumulated since the beginning of the pandemic, important uncertainties remain regarding the long-term clinical, functional, radiological, and metabolic consequences of SARS-CoV-2 infection. Identification of post-COVID-19 complications is therefore essential for appropriate recognition and management. This study aimed to evaluate the long-term complications of COVID-19 at 3 and 9 months after infection. Methods: This prospective study was conducted at Inonu University Turgut Ozal Medical Center. Patients who presented with active post-COVID-19 complaints or for routine follow-up were enrolled. Participants were evaluated at the pulmonology outpatient clinic at 3 and 9 months. At each visit, persistent or new-onset symptoms were assessed, and pulmonary function tests (PFT), the six-minute walk test (6MWT), echocardiography (ECHO), and thoracic computed tomography (CT) were performed as clinically indicated. Patients were stratified into three groups according to the severity of acute illness: outpatient, ward-hospitalized, and ICU-hospitalized. Results: A total of 205 patients (120 male, 85 female) were included. Male patients had significantly higher rates of ward and ICU hospitalization than female patients (p = 0.006). At 9 months, 85.3% of patients had at least one persistent symptom; dyspnea (69.6%), cough (35.6%), and chest pain (32.5%) were the most common. FVC showed a statistically significant increase between months 3 and 9 (p = 0.014), and the 6MWT distance improved significantly (423.56 m vs. 464.10 m; p = 0.008). Ground-glass opacity, present in 90.2% of patients at admission, persisted in 44.3% at 9 months (p < 0.001). Reticular opacities, pleuroparenchymal bands, and mosaic perfusion patterns increased over time. ICU patients had significantly lower ejection fraction values compared with ward and outpatient groups at 9 months (p = 0.046). During follow-up, 13 patients developed pulmonary embolism and 7 developed new-onset diabetes mellitus. Conclusions: Despite the well-characterized acute phase, the long-term sequelae of COVID-19 remain a significant clinical challenge. Identification of late complications is critical for reducing morbidity and understanding the long-term societal and healthcare burden of the pandemic. Multidisciplinary long-term follow-up is warranted, particularly for patients who experienced severe acute illness. Full article

Background/Objectives: Hospital-wide bed pooling is widely used in bed-management reform to reduce ward-level mismatch and improve the use of scarce inpatient capacity. However, formally pooled beds are not automatically usable beds. Cross-ward reassignment may require coordination, placement judgment, and timely execution, especially when several wards are under pressure. This study examines hospital bed governance as a healthcare management problem of where to draw the boundary between local protection and centralized pooling. Methods: We develop an $\alpha$-based governance framework that places full decentralization, bounded centralization, and full centralization within a common design space. The parameter $\alpha$ determines how much ward-level capacity is pooled and how much remains locally protected. The analysis first establishes a frictionless pooling benchmark, and then introduces coordination friction, stress-state pooled-allocation imperfection, and the protective value of local capacity. Scenario-based computational experiments examine the mechanism across operating conditions, alternative friction specifications, and multi-ward extensions. Results: In the frictionless benchmark, full centralization weakly dominates because it has the broadest feasible allocation set. When pooled allocation remains fully effective, full centralization is not substantively outperformed. Coordination friction can move the raw maximizing boundary inward, but this movement does not necessarily imply a meaningful improvement over full centralization. When reassignment becomes less reliable in high-pressure states, however, an interior governance boundary can become substantively attractive by preserving some locally accessible capacity. Conclusions: The findings do not reject centralized pooling. They suggest that bed reform should evaluate both the formal scope of pooling and the operational usability of pooled capacity under pressure. Full article

Background: Candidemia remains a major cause of morbidity and mortality among hospitalized patients. The emergence of Candidozyma auris has added further complexity due to its persistence in healthcare settings and its high rates of antifungal resistance. Comparative real-world data between Candidozyma auris and Candida spp. candidemia remain limited. Methods: We conducted a retrospective cohort study that included adult patients with candidemia, admitted to a tertiary infectious diseases hospital in Romania between August 2018 and August 2025. Risk factors, including medical history, previous hospitalizations, clinical characteristics, laboratory parameters, antifungal susceptibility patterns, treatment, and outcomes, were compared in patients with Candidozyma auris- and Candida spp.-positive blood cultures. Overall survival and prognostic factors were evaluated using univariable and multivariable Cox-proportional hazards models. Results: Sixty-one patients with candidemia were included; out of them, 24 (39.3%) had Candidozyma auris-positive blood cultures. Candidozyma auris infections, which emerged later during the study period, occurred after a significantly longer period of hospitalization compared with Candida spp. candidemia (median 52.5 vs. 20 days, p < 0.001). Azole resistance was almost universal among Candidozyma auris isolates (95.8%), whereas Candida species displayed significantly lower resistance rates and a broader susceptibility spectrum (p < 0.001). Inflammatory markers were comparable between groups; however, Candidozyma auris candidemia was associated with lower neutrophil counts and lower neutrophil-to-lymphocyte ratios at diagnosis (p = 0.020). Persistent candidemia at day 7 occurred more frequently in Candidozyma auris infections (6 vs. 2 patients; p = 0.05) and was universally fatal. Overall, in-hospital mortality was high (70.5%) and did not differ between Candidozyma auris and Candida spp. candidemia. In multivariable analysis, thrombocytopenia < 100,000/μL was independently associated with mortality (HR 2.34, 95% C.I. 1.20–4.56; p = 0.012). Conclusions: In this 7-year study at a Romanian tertiary center, Candidozyma auris emerged as a major healthcare-associated pathogen affecting patients with significantly prolonged hospitalization (median 52.5 days). Despite near-universal azole resistance (95.8%), mortality was exceptionally high (70.5%) and was comparable between groups, with pathogen type not independently associated with outcome after multivariable adjustment. Moderate thrombocytopenia (<100,000/μL) and persistent candidemia identified patients at particularly high risk of death, underscoring the need for early risk stratification, optimized antifungal management, and enhanced diagnostic vigilance, both in intensive care and general wards. Full article