P15. Distribution and prevalence of fungemia: a 5-year retrospective multicentric survey in Venetian region, Italy

Invasive fungal infections (IFIs) are a major global health issue.¹ Candida species, especially Candida albicans, are the leading cause of IFIs. Non-albicans Candida (NAC) species such as C. glabrata, C. tropicalis, and C. parapsilosis have become more prevalent.² This study examines the distribution of fungal species in blood cultures and the trend of antifungal susceptibility in the Venetian region of Italy.

This retrospective study analyzed fungal isolates from blood cultures collected between January 2019 and December 2023 in the Venetian region. Samples were sourced from 5 hospitals, 17 long-term care facilities, and 28 territory withdrawal centers. Fungemia episodes were defined as positive blood cultures for yeasts or molds. Isolates from the same patient within 30 days were excluded.

693 fungal isolates were identified from 11 552 blood cultures C. albicans was the most common species (51.9%), followed by C. parapsilosis (23.2%) and N. glabratus (11.5%). The proportion of C. albicans decreased from 60% in 2019 to 43.1% in 2023, while NAC, including C. parapsilosis and C. tropicalis, showed an increase. The highest incidence of cases occurred in medical wards (61.9%), with a notable rise in NAC species in 2023. Surgical wards and ICUs also experienced steady cases, but ICU cases showed a decline in candidemia from 2021 to 2023. Antifungal resistance trends indicated minimal resistance to liposomal amphotericin B (L-AMB) and azoles for C. albicans. C. parapsilosis exhibited a significant rise in resistance to L-AMB, while N. glabratus showed high fluconazole resistance, peaking at 85.7% in 2021.

This five-year study highlights a significant shift in fungemia epidemiology in the Venetian healthcare region, with NAC species surpassing C. albicans in prevalence, particularly in medical wards. NAC species, such as C. parapsilosis and N. glabratus, have risen substantially, reflecting global trends. Medical wards accounted for most cases, with NAC species representing 54.5% of isolates in 2023. The study also revealed increasing antifungal resistance, notably in C. parapsilosis and N. glabratus. These trends emphasize the need for improved diagnostic methods, infection prevention, and antifungal stewardship. However, the study's limitations include the absence of clinical data and patient outcomes, suggesting the need for future prospective studies integrating epidemiological and clinical data.