Objective: The primary objective of this study was to investigate whether time to blood culture positivity (TTP) can reliably differentiate Candida species and to evaluate their antifungal susceptibility profiles to support more effective clinical decision-making.
Materials and Methods: This retrospective study was conducted at Sivas Numune Hospital between January 1, 2022 and February 28, 2025. Adult patients (>18 years) with positive blood cultures for Candida species were included.
Results: A total of 101 blood culture bottles from 70 patients were evaluated. C. albicans was the most common isolate (51.5%), followed by C. glabrata (21.5%). The shortest TTP was observed for C. tropicalis (19 hours), and the longest for C. glabrata (42 hours). When C. albicans and C. tropicalis were classified as early TTP species and C. glabrata and C. parapsilosis as late TTP species, the mean TTP values were 21 and 35 hours, respectively. Receiver operating characteristic (ROC) analysis identified a TTP cut-off value of 28 hours as optimal for predicting the early TTP group (area under the curve: 0.751), indicating moderate discriminatory ability. Early TTP species were generally susceptible to fluconazole, whereas resistance was more frequent among late TTP species.
Conclusion: Blood culture positivity times differ among Candida species. Early TTP species, such as C. albicans and C. tropicalis, were more likely to be fluconazole-susceptible, suggesting that fluconazole may be an appropriate option for empirical therapy in such infections.