{"doi":"10.1093/ofid/ofaf251","title":"Candidemia in Left Ventricular Assist Device Recipients: Incidence, Risk Factors, and Outcomes","abstract":"Abstract Background Candidemia (Candida bloodstream infection [C-BSI]) in left ventricular assist device (LVAD) recipients is poorly understood. This study aimed to investigate the incidence, risk factors and outcomes of C-BSI in LVAD recipients. Methods We screened 656 adults who underwent LVAD implantation at our institution from 1 January 2015 to 4 April 2024. Patients with C-BSI (n = 18) were compared with 2 control groups: (1) matched LVAD recipients with no bloodstream infection (N-BSI; matched 1:5; n = 90) to determine risk factors for C-BSI and (2) unmatched LVAD recipients with bacteremia (bacterial BSI [B-BSI]; n = 79) to compare mortality and infectious complication rates. A random forest model identified key predictive factors for C-BSI. Kaplan-Meier survival curves were used for time-to-event analyses. Results Median time to C-BSI was 20 days after implantation (interquartile range, 6–42 days). Compared to N-BSI, C-BSI were more likely to require perioperative temporary mechanical circulatory support (9 patients [50%] vs 8 [8.9%], respectively), renal replacement therapy (12 [67%] vs 6 [6.7%]), total parenteral nutrition (6 [33%] vs 2 [2.2%]), and prolonged postoperative mechanical ventilation (for 12 days vs 1 day) (all P < .001). A random forest model identified ventilation duration, renal replacement therapy, and total parenteral nutrition as top predictors of C-BSI. In terms of outcomes, C-BSI was more likely to lead to device endocarditis than B-BSI (in 5 [28%] vs 7 [9.1%], respectively; P = .008) and was associated with shorter median survival after infection (25 [interquartile range, 12 to not estimable due to censoring] vs 490 [54 to not estimable due to censoring] days; P = .04). Conclusions C-BSI occurs early in LVAD recipients and is associated with a high mortality rate. Identified risk factors identified may guide antifungal prophylaxis or early empiric antifungal treatment in this susceptible patient population.","journal":"Open Forum Infectious Diseases","year":2025,"id":533584,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9553,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":651863,"name":"Stephanie M. Pouch","orcid":"0000-0002-5628-2444","position":1,"is_corresponding":false},{"id":385545,"name":"Lindsay M. Busch","orcid":"0000-0002-5332-5883","position":2,"is_corresponding":false},{"id":1415373,"name":"Taylor Hayes","orcid":"0009-0001-3251-6509","position":3,"is_corresponding":false},{"id":1415374,"name":"Susie Sennhauser","orcid":"0000-0001-5817-786X","position":4,"is_corresponding":false},{"id":859071,"name":"Joshua L. Chan","orcid":"0000-0001-7220-561X","position":5,"is_corresponding":false},{"id":319849,"name":"Emily M. Eichenberger","orcid":"0000-0002-2469-0638","position":6,"is_corresponding":false},{"id":1415372,"name":"Rebecca Anderson","orcid":"0000-0003-3862-871X","position":0,"is_corresponding":true}],"reference_count":37,"raw_metadata":null,"created_at":"2026-07-19T02:51:32.301795Z","pmid":"40376190","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}