Volume 31, Number 10—October 2025
CME ACTIVITY - Research
Recent Systemic Antifungal Exposure and Nonsusceptible Candida in Hospitalized Patients, South Africa, 2012–2017
, and for GERMS-SA
Table 1
Baseline characteristics by prior exposure to antifungal drugs in patients >90 days of age with culture-confirmed candidemia at sentinel hospitals, South Africa, 2012–2017*
| Characteristic | No prior exposure, n = 1,132 | Prior exposure, n = 210 | All patients, N = 1,342 | p value |
|---|---|---|---|---|
| Median age, y (IQR) |
35 (8–55) |
33 (3–54) |
34 (8–55) |
0.16† |
| Age group | 1,342 | |||
| Older infants, 90 d–1 y | 112 (10) | 31 (15) | 143 | 0.071 |
| Children and adolescents, >1 y–17 y | 198 (17) | 40 (19) | 238 | |
| Adults, 18 y–64 y | 663 (59) | 105 (50) | 768 | |
| Elderly, >65 y |
159 (14) |
34 (16) |
193 |
|
| Sex | 1,341 | |||
| F | 531 (47) | 91 (43) | 622 | 0.335 |
| M |
600 (53) |
119 (57) |
719 |
|
| Year of diagnosis | 1,342 | |||
| 2012–2013 | 288 (25) | 63 (30) | 351 | <0.001 |
| 2014–2015 | 215 (19) | 27 (13) | 242 | |
| 2016 | 307 (27) | 37 (18) | 344 | |
| 2017 |
322 (28) |
83 (40) |
405 |
|
| Province§ | 1,342 | |||
| Gauteng | 554 (49) | 74 (35) | 628 | <0.001 |
| Other |
578 (51) |
136 (65) |
714 |
|
| Healthcare sector | 1,342 | |||
| Private | 99 (9) | 49 (23) | 148 | <0.001 |
| Public |
1,033 (91) |
161 (77) |
1,194 |
|
| Prior hospitalization (<90 d)¶ | 1,328 | |||
| No | 251 (22) | 35 (17) | 286 | |
| Yes |
869 (76) |
173 (83) |
1,042 |
|
| ICU admission | 1,321 | |||
| No | 511 (46) | 68 (33) | 579 | <0.001 |
| Yes |
601 (54) |
141 (67) |
742 |
|
| Hospital stay before infection onset, d | 1309 | |||
| Median (IQR) | 10 (3–22) | 23 (12–41) | 11 (4–26) | <0.001† |
| <2 | 270 (25) | 7 (3) | 277 | <0.001‡ |
| 3–7 | 191 (17) | 23 (11) | 214 | |
| 8–14 | 227 (21) | 37 (18) | 264 | |
| 15–21 | 129 (12) | 31 (15) | 160 | |
| >22 |
285 (26) |
109 (53) |
394 |
|
| Systemic antimicrobial drug use | 1,081 | |||
| No | 342 (30) | 31 (15) | 373 | <0.001 |
| Yes |
781 (70) |
177 (85) |
958 |
|
| Mechanical ventilation | 1,316 | |||
| No | 749 (68) | 126 (61) | 875 | 0.049 |
| Yes |
359 (32) |
82 (39) |
441 |
|
| CVC in situ | 1,314 | |||
| No | 505 (46) | 51 (25) | 556 | <0.001 |
| Yes |
603 (54) |
155 (75) |
758 |
|
| TPN | 1,308 | |||
| No | 876 (79) | 120 (59) | 996 | <0.001 |
| Yes |
230 (21) |
82 (41) |
312 |
|
| HIV status | 771 | |||
| Seronegative | 386 (59) | 78 (68) | 464 | 0.069 |
| Seropositive | 270 (41) | 37 (32) | 307 | |
*Values are no. (%) except as indicated. p value determined by Pearson χ2 test except as indicated. Numbers for each category indicate no. patients for whom that information was available. Prior antifungal exposure was <14 d before blood culture collection. CVC, central venous catheter; ICU, intensive care unit; TPN, total parenteral nutrition. †p value determined by Wilcoxon rank-sum test. ‡p value determined by Fisher exact test. §Other province includes Limpopo, Mpumalanga, KwaZulu-Natal, Free State, North West, Northern Cape, Western Cape, Eastern Cape Province. ¶Prior hospital admission was recorded within the previous 90 d before current admission.