{
  "abstract": "Background: Candidemia displays significant clinical heterogeneity in critically ill patients. This study aimed to identify distinct clinical phenotypes and to assess their association with 90-day mortality. Methods: We conducted a multicenter retrospective cohort study of 492 intensive care unit (ICU) patients with candidemia from 16 French ICUs (2015-2023). We performed a factor analysis of mixed data (FAMD) incorporating both categorical and continuous baseline variables, followed by hierarchical clustering on principal components (HCPC). Survival analysis was performed with Kaplan-Meier curves and Cox proportional hazards models. Results: Overall, 90-day mortality for the 492 patients (median age: 64 years, 69.1% male) with candidemia was 62.6%. Three different phenotypes emerged from FAMD followed by HCPC: Phenotype 1 (n = 70, 14.2%) comprised patients with severe immunosuppression, mostly due to hematological malignancies (82.9%), and high severity scores (SAPS II:70); Phenotype 2 (n = 223, 45.3%) corresponded to elderly cirrhotic patients (19.3%) with early-onset digestive candidemia; Phenotype 3 (n = 199, 40.5%) comprised younger patients with lower severity scores and catheter-related candidemia. Mortality differed significantly between phenotypes: 72.9% (Phenotype 1), 70.4% (Phenotype 2), and 50.3% (Phenotype 3) (p < 0.001). Independent predictors of mortality included age (aHR: 1.01, 95% CI: 1.00-1.02; p = 0.003), cirrhosis (aHR: 1.90, 95% CI: 1.39-2.60; p < 0.001), SAPS II (aHR: 1.01, 95% CI: 1.01-1.02; p < 0.001), echinocandin use (aHR = 0.49, 95% CI: 0.39-0.63; p < 0.001) and proven catheter-related candidemia (protective; aHR: 0.48, 95% CI: 0.33-0.69; p < 0.001). Immunodepression was not associated with mortality. Conclusion: Unsupervised clustering identified three clinically different candidemia phenotypes with different outcomes. Cirrhosis, higher age and illness severity were associated with mortality, whereas a catheter-related source of infection was protective.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 34,
  "authors": [
    {
      "name": "Florian Reizine"
    },
    {
      "name": "Juliette Henry"
    },
    {
      "name": "Luc Desmedt"
    },
    {
      "name": "Christophe Camus"
    },
    {
      "name": "Valentin Coirier"
    },
    {
      "name": "François Arrivé"
    },
    {
      "name": "Estelle Burban"
    },
    {
      "name": "Gabriel Eustache"
    },
    {
      "name": "Tony Belleville"
    },
    {
      "name": "Antoine Marc"
    },
    {
      "name": "Jolan Malherbe"
    },
    {
      "name": "Pierre Bouju"
    },
    {
      "name": "Paul Jaubert"
    },
    {
      "name": "Olivier Lesieur"
    },
    {
      "name": "Maxime Leclerc"
    },
    {
      "name": "Pierre Fillâtre"
    },
    {
      "name": "Aurélien Frérou"
    },
    {
      "name": "Renaud Prével"
    },
    {
      "name": "Nolwenn Mainguy"
    },
    {
      "name": "Anne Cady"
    },
    {
      "name": "Florent Morio"
    },
    {
      "name": "Solène Le Gal"
    },
    {
      "name": "Estelle Perraud"
    },
    {
      "name": "Laurence Delhaes"
    },
    {
      "name": "Sébastien Imbert"
    },
    {
      "name": "Hélène Guegan"
    },
    {
      "name": "Julie Bonhomme"
    },
    {
      "name": "Marc Pihet"
    },
    {
      "name": "Clarisse Dupin"
    },
    {
      "name": "Agathe Delbove"
    },
    {
      "name": "Damien Du Cheyron"
    },
    {
      "name": "Yoann Launey"
    },
    {
      "name": "Cécile Aubron"
    },
    {
      "name": "Jean-Pierre Gangneux"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/0bd98gg8emzp6.bib",
  "cited_by": 2,
  "doi": "10.1186/s13054-026-05964-4",
  "fulltext_url": null,
  "id": "0bd98gg8emzp6",
  "issns": [
    "1364-8535",
    "1466-609X"
  ],
  "landing_url": "https://hal.science/hal-05675809v1",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "hal",
      "0.sdv"
    ],
    [
      "hal",
      "1.sdv.mp"
    ],
    [
      "hal",
      "2.sdv.mp.myc"
    ],
    [
      "openalex",
      "2725|Antifungal resistance and susceptibility"
    ]
  ],
  "openalex": "W7166297388",
  "pdf_url": "https://hal.science/hal-05675809/document",
  "pmcid": null,
  "pmid": "42365321",
  "published": "2026-10-14",
  "publisher": "BioMed Central",
  "ris": "https://research.draconitic.com/paper/0bd98gg8emzp6.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:57Z",
      "native_id": "hal-05675809",
      "source": "hal",
      "url": "https://hal.science/hal-05675809v1"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "hal:1.sdv.mp",
      "subfield": "microbiology"
    }
  ],
  "title": "Decoding candidemia in critically ill patients: unsupervised clustering identifies three unique phenotypes",
  "title_text": "Decoding candidemia in critically ill patients: unsupervised clustering identifies three unique phenotypes",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:57Z",
  "url": "https://research.draconitic.com/paper/0bd98gg8emzp6",
  "venue": "Critical Care",
  "versions": []
}