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

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dc.authoridguler, ozlem/0000-0002-7018-7224
dc.contributor.authorGuler, Ozlem
dc.contributor.authorUzel, Murat
dc.contributor.authorTepe, Dilsat
dc.contributor.authorAksoy, Firdevs
dc.contributor.authorCinar, Gule
dc.contributor.authorMemikoglu, Kemal Osman
dc.contributor.authorDurdu, Bulent
dc.date.accessioned2025-10-24T18:09:16Z
dc.date.available2025-10-24T18:09:16Z
dc.date.issued2025
dc.departmentMalatya Turgut Özal Üniversitesi
dc.description.abstractThis multicentre retrospective study investigated the epidemiology, clinical characteristics, and fluconazole resistance rates of Candida species in osteoarticular infections across Turkey as well as the factors influencing complete recovery. Data were gathered from 73 adult patients diagnosed with proven or probable Candida-associated osteoarticular infections between 2015 and 2025 from 20 healthcare centres. The most common clinical presentation was spondylodiscitis, followed by the involvement of phalangeal bones in the hands and feet. Non-albicansCandida species accounted for 37/73 cases (50.7%), with Candida parapsilosis being the most frequent. Fluconazole resistance was low among C. albicans isolates (3%) but higher among non-albicans yeasts (27%). Bacterial co-infection, predominantly Gram-positive bacteria, was detected in 52.1% of cases. Diabetes was present in 50/73 patients (68.5%), particularly insulin-dependent diabetes, and was a prominent comorbidity that may have also contributed as a predisposing factor. Radiological detection of osteomyelitis was achieved in 69.9% of patients. Fluconazole was the most commonly used antifungal agent (74%) with a median treatment duration of 90 days. Multivariate analysis revealed that surgical debridement was significantly associated with a higher odds of clinical recovery (adjusted odds ratio [aOR], 5.764; 95% confidence interval [CI], 1.360-24.434; P = .017), whereas diabetes mellitus was significantly associated with a lower odds of total recovery (aOR, 0.205; 95% CI, 0.053-0.792; P = .022). In conclusion, this multicentre study provides epidemiological data and fluconazole resistance rates of Candida species causing osteoarticular infections in Turkey, highlights the occurrence of C. auris in this cohort, and identifies surgical intervention and diabetes mellitus as factors significantly associated with recovery. This study analysed bone and joint infections with the yeast Candida from multiple Turkish hospitals over 10 years. Non-Candida albicans species were the most common (50.7%). The spine bones and discs were mostly affected. Diabetes was a key risk factor. Treatment generally lasted around 90 days.
dc.description.sponsorshipAPC [GOKAEK-2024/04.05]; Turkish Society of Clinical Microbiology and Infectious Diseases (KLIMIK)
dc.description.sponsorshipThe authors gratefully acknowledge the support of the Turkish Society of Clinical Microbiology and Infectious Diseases (KLIMIK), Fungal Infections Working Group, for their invaluable assistance in data collection from diverse regions of Turkey. We also acknowledge Associate Professor Dr. Sibel Balc & imath; from Kocaeli University, Faculty of Medicine, Department of Biostatistics and Medical Informatics, Kocaeli, Turkey, for statistical analysis of the data. The authors confirm that the ethical policies of the journal, as noted on the journal's author guidelines page, have been adhered to, and appropriate ethical review committee approval has been received. This study was conducted in accordance with the Declaration of Helsinki of the World Medical Association revised in 2013 for experiments involving humans, as well as with the protocols of the Ethics Committee of Kocaeli University Faculty of Medicine. The project was assigned the number 2024/40 and received approval under the code GOKAEK-2024/04.05. This study was registered with ClinicalTrials.gov under identifier NCT06788782. The authors declare that this report does not contain any personal information that could lead to the identification of the patient(s) and/or volunteers.
dc.identifier.doi10.1093/mmy/myaf080
dc.identifier.issn1369-3786
dc.identifier.issn1460-2709
dc.identifier.issue9
dc.identifier.pmid40888626
dc.identifier.urihttps://doi.org/10.1093/mmy/myaf080
dc.identifier.urihttps://hdl.handle.net/20.500.12899/3562
dc.identifier.volume63
dc.identifier.wosWOS:001567548200001
dc.identifier.wosqualityN/A
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherOxford Univ Press
dc.relation.ispartofMedical Mycology
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_20251023
dc.subjectCandida; arthritis; bone diseases; infectious; osteomyelitis; spondylodiscitis
dc.titleEpidemiology and outcomes of Candida-associated osteoarticular infections: A multicentre retrospective study from Turkey
dc.typeArticle

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