Increasing spread of Candida auris and investigation of risk factors for invasive infections in colonized patients

Tuğba Arslan Gülen; Nida Akar; Ebru Oruç; Tuba Turunç; Koray Daş; Nurdan Ünlü; Aygün Uğurbekler

doi:10.3855/jidc.20891

Increasing spread of Candida auris and investigation of risk factors for invasive infections in colonized patients

Authors

Tuğba Arslan Gülen Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Adana City Training and Research Hospital, Adana, Türkiye
Nida Akar Department of Medical Mycology, University of Health Sciences, Adana City Training and Research Hospital, Adana, Türkiye
Ebru Oruç Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Adana City Training and Research Hospital, Adana, Türkiye https://orcid.org/0000-0001-7956-7306
Tuba Turunç Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Adana City Training and Research Hospital, Adana, Türkiye
Koray Daş Department of General Surgery, University of Health Sciences, Adana City Training and Research Hospital, Adana, Türkiye https://orcid.org/0000-0002-3979-9046
Nurdan Ünlü Department of Anesthesiology and Intensive Care, University of Health Sciences, Adana City Training and Research Hospital, Adana, Türkiye https://orcid.org/0000-0002-0460-4472
Aygün Uğurbekler Hospital Infection Control Committee, Adana City Training and Research Hospital, Adana, Türkiye

DOI:

https://doi.org/10.3855/jidc.20891

Keywords:

Candida auris, Candida colonization, infection, risk factors, surveillance, antifungal resistance

Abstract

Introduction: Candida auris is a yeast that has a high mortality rate in critically ill patients and is resistant to many antifungal agents enhancing its clinical importance. Our study identifies the risk factors for C. auris invasive infection, antifungal susceptibility, and outcomes.

Methodology: A total of 100 adults with C. auris isolated in any clinical specimen between 07.01.2022 and 31.12.2023 were enrolled in this retrospective cohort study. Data were obtained via retrospective screening of patient files. C. auris identification was performed by MALDI-TOF MS. Antifungal susceptibility was carried out by VITEK 2 and CDC methodology. Colonized and infected patients were compared to assess the risk factors for and outcomes of invasive infection.

Results: Twenty (20%) patients developed invasive infections, with 16 (80%) having candidemia. Age, Candida score, prior antifungal agent use, number of previously used antibiotics ≥ 3, presence of central venous catheter or nasogastric catheter, and being monitored out of burn unit were the risk factors, and Candida score was identified as an independent risk factor for invasive infection development. Of the isolates, 55% were resistant to fluconazole and 100% were resistant to amphotericin B. No micafungin resistance was detected. The overall mortality rate in patients with invasive infection was 75%.

Conclusions: Knowing the risk factors for invasive infection will help early initiation of empirical antifungal therapy by ensuring early identification of high-risk patients, and Candida score appears to be an effective method for this. Revealing antifungal susceptibility will also guide the selection of appropriate empirical treatment.

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Published

2025-08-31

How to Cite

Arslan Gülen T, Akar N, Oruç E, Turunç T, Daş K, Ünlü N, Uğurbekler A (2025) Increasing spread of Candida auris and investigation of risk factors for invasive infections in colonized patients. J Infect Dev Ctries 19:1245–1252. doi: 10.3855/jidc.20891

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Issue

Vol. 19 No. 08: August 2025

Section

Original Articles

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