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Epidemiology and outcomes of Candida-associated osteoarticular infections: A multicentre retrospective study from Turkey

Summary

Researchers in Turkey studied 73 patients with rare bone and joint infections caused by Candida fungi over 10 years. They found that about half of the infections were caused by species other than the common C. albicans, with some showing resistance to fluconazole antibiotics. Surgical procedures to clean out infected tissue significantly improved patient recovery, while patients with diabetes had worse outcomes and recovered less completely.

Background

Candida-associated osteoarticular infections are rare complications with an incidence of 0.4% among adult candidaemia cases. These infections are challenging to diagnose and manage, often requiring prolonged antifungal therapy and aggressive surgical intervention. The epidemiology of Candida species in osteoarticular infections varies globally, with emerging pathogens like C. auris representing new challenges.

Objective

This multicentre retrospective study investigated the epidemiology, clinical characteristics, fluconazole resistance rates of Candida species causing osteoarticular infections across Turkey. The study also aimed to identify factors influencing complete clinical recovery and assess the role of emerging fungal pathogens such as C. auris in these rare infections.

Results

Non-albicans Candida species accounted for 50.7% of cases, with C. parapsilosis being most frequent. Fluconazole resistance was low in C. albicans (3%) but higher in non-albicans species (27%). Spondylodiscitis was the most common presentation, followed by phalangeal bone involvement. Surgical debridement was significantly associated with higher odds of complete recovery (aOR 5.764, P=.017), while diabetes mellitus was associated with lower odds of total recovery (aOR 0.205, P=.022).

Conclusion

This multicentre study provides epidemiological data and fluconazole resistance rates of Candida species causing osteoarticular infections in Turkey and documents the emergence of C. auris. Surgical intervention is a critical factor for achieving complete clinical recovery, while diabetes mellitus significantly impairs recovery outcomes in these challenging infections.
  • Published in:Medical Mycology,
  • Study Type:Retrospective Cohort Study,
  • Source: 10.1093/mmy/myaf080; PMID: 40888626
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