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Shaymaa A Abdalal,1,2 Dalya M Attallah,3 Jawahir A Mokhtar,4 Reham Mohammedsaeed Kaki,5,6 Hatoon A Niyazi,3,4 Hanouf A Niyazi,4 Moroj A Aldarmasi1 1Community Medicine Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 2Preventive Medicine Unit, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia; 3Clinical and Molecular Microbiology Laboratories, King Abdulaziz University Hospital, Jeddah, Saudi Arabia; 4Clinical Microbiology and Immunology Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 5Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 6Department of Infectious Disease & Infection Control and Environmental Health, King Abdulaziz University Hospital, Jeddah, Saudi ArabiaCorrespondence: Shaymaa A Abdalal, Community Medicine Department, Faculty of Medicine, King Abdulaziz University, P.O. Box 80205, Jeddah, Makkah, Saudi Arabia, Email sabdalal@kau.edu.saBackground: Candidemia, a bloodstream infection caused by Candida species, poses a significant clinical challenge, especially in immunocompromised individuals and intensive care unit (ICU) patients. Prompt diagnosis and treatment are crucial, as delayed antifungal therapy is associated with higher mortality rates. This study, conducted at King Abdulaziz University Hospital (KAUH) in Saudi Arabia, aimed to investigate the clinical and microbiological aspects of candidemia.Methods: This study is a retrospective analysis, KAUH in Saudi Arabia, using data from January 2017 to March 2021. Advanced fungal diagnostic technologies, including MALDI-TOF MS, BioFire, and Vitek 2 systems, were utilized. Patient demographics, clinical characteristics, Candida species distribution, and antifungal susceptibility were assessed. Univariate, bivariate, and multivariate statistical analyses were conducted.Results: Among 418 patients, Candida albicans was the most prevalent species (32.1%), followed by C. tropicalis (23.4%) and C. parapsilosis (18.4%). Various Candida species exhibited different antifungal susceptibility patterns, with high sensitivity to Amphotericin B (95%) and Fluconazole (94%). Sensitivity to Caspofungin varied significantly among species (p = 0.023), with C. parapsilosis showing the highest sensitivity (95%). The overall mortality rate was 67%. None of Candida Species exhibited a statistically significant association with death, however other factors including age, autoimmune diseases, and dialysis were associated with increased mortality risk.Conclusion: This study provides valuable insights into the epidemiology and clinical characteristics of candidemia at KAUH, highlighting the importance of species identification and tailored antifungal therapy. These findings can inform strategies to improve patient care and infection control in Saudi Arabian healthcare settings, contributing to global efforts to mitigate the impact of invasive fungal infections.Keywords: candidemia, Candida species, antifungal susceptibility, epidemiology, Saudi Arabia