Risk Factors Associated with Candida auris Candidemia: A Single-Center Retrospective Case-Control Study
Epidemiology and Infection, vol.153, 2025 (SCI-Expanded, Scopus)
- Publication Type: Article / Article
- Volume: 153
- Publication Date: 2025
- Doi Number: 10.1017/s0950268825100721
- Journal Name: Epidemiology and Infection
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CINAHL, Educational research abstracts (ERA), EMBASE, Environment Index, Hospitality & Tourism Complete, Hospitality & Tourism Index, MEDLINE, Directory of Open Access Journals
- Keywords: antifungal resistance, Candida auris, Candidozyma auris, critical care, risk factors
- Ankara Yıldırım Beyazıt University Affiliated: Yes
Abstract
Candida auris has emerged as a major nosocomial pathogen due to multidrug resistance, outbreak potential, and high mortality in critically ill patients. Identifying risk factors for C. auris candidemia is essential for prevention and infection control. In this single-center, retrospective case-control study, we analyzed adults with C. auris candidemia (n=52) and matched controls (n=104) hospitalized between February 2019 and October 2024. Matching was based on hospital unit and blood culture timing. Clinical and epidemiological variables were compared, and multivariate logistic regression identified independent risk factors. Antifungal susceptibility and 14-and 28-day all-cause mortality were evaluated as secondary outcomes. Independent risk factors included recent hospitalization (OR 7.93), prolonged hospital stay (OR 1.01), prior broad-spectrum antibiotic use (OR 46.20), central venous catheter (OR 3.88), sepsis (OR 9.43), and high Candida Colonization Index (OR 14.10). All-cause mortality at 14 and 28 days was 30.8% and 46.2%, respectively. Fluconazole resistance was 96%, while 8.7% of isolates were pandrug resistant. C. auris candidemia represents a serious clinical challenge with substantial mortality and modifiable risk factors. Strengthening antimicrobial stewardship, colonization surveillance, and early recognition in high-risk patients may reduce its impact.