Clinical characteristics, antifungal exposure, and 90-day mortality of PCR-identified candidemia according to presumed species-level fluconazole susceptibility.

Nearly half of PCR-identified candidemia cases involve species with presumed fluconazole nonsusceptibility, impacting patient outcomes and treatment strategies.

• Why it matters: Accurate early identification of Candida species is crucial for guiding effective antifungal therapy, yet the clinical significance of presumed susceptibility categories remains uncertain, risking suboptimal treatment.
• What they did: A retrospective cohort study analyzed 1,171 adults with PCR-identified candidemia, categorizing them into presumed fluconazole susceptible or nonsusceptible groups, and evaluated clinical features, treatments, and 90-day mortality using IPTW and Cox models.
• The result: Findings showed that presumed FNS species are linked to distinct patient profiles and mortality risks, with lower survival in the susceptible group after adjustment, emphasizing the importance of rapid species identification for informed treatment decisions.