Characteristics and mitigation measures of Candida auris infection: descriptive analysis from a quaternary care hospital in Saudi Arabia, 2021-2022
Open accessAbstract
OBJECTIVE: To analyze the characteristics of C. auris cases, and to describe the interventions applied for improving the diagnosis and controlling the transmission. METHOD: Medical records of C. auris cases reported between January 2021 until June 2022 at King Saud Medical City (KSMC), Riyadh, Kingdom of Saudi Arabia have been reviewed. We analyzed the demographic and clinical characteristics of the cases to illustrate the possible contributing factors with C. auris infection. A multidisciplinary committee has been formulated to investigate the potential source of the outbreak among clusters of cases in the intensive care units (ICU). A bundle of mitigation measures has been applied which was successful to contain the outbreak. RESULTS: During the study period, a total of 129 cases of C. auris were identified, their mean age is 47 ± 22.3 SD, and 72.1% are males. 57% of cases were colonized, all of them were identified through active screening. A number of comorbidities were present including 27.9% were having hypertension, 27.1% with diabetes, 22.5% with COVID-19 and 20.2% with respiratory diseases. The average length of stay before reported positive was 36.23 days. 78.3% of those patients were in the critical care unit, 73.6% with vascular catheter, 88% with urinary catheters and 66.7% with mechanical ventilation. The vast majority of patients were using multiple antibiotics (86%). As per the univariate logistic model, risk factors significantly associated with mortality were (Age, Trauma RTA, ICU, Vascular Access, Foley Catheters, Mechanical Ventilation, Tracheostomy and Endotracheal Tubes) with p values (0.0038, 0.0159, 0.0108, 0.0122, 0.0071, <.0001, 0.0148 and 0.0107), respectively. Multivariate logistic regression showed that having a Foley Catheter was the only statistically significant factor associated with mortality. CONCLUSION: This retrospective analysis highlights the main characteristics associated with C. auris-infected patients. In addition, it highlights the effectiveness of the bundle of mitigation strategies applied to limit the spread of C. auris in healthcare facilities.
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C. auris skin colonization frequently occurs in patients recently exposed to prolonged courses of broad-spectrum antibiotics, particularly carbapenems and vancomycin, with 43.3% of colonized patients treated with carbapenems, and 41.7% with vancomycin.
“C. auris skin colonization frequently occurs in patients recently exposed to prolonged courses of broad-spectrum antibiotics, particularly carbapenems and vancomycin, with 43.3% of colonized patients treated with carbapenems, and 41.7% with vancomycin [40–43,45–47].”
From Host–Candida auris interactions in the skin (2026) · cites this paper as [43]
The Results report that 57% of cases were colonized and 86% of all C. auris patients received multiple antibiotics; the Discussion also notes antibiotic exposure within 14 days before a positive specimen. Neither section identifies prolonged broad-spectrum courses or reports carbapenem and vancomycin use among colonized patients, so the claimed 43.3% and 41.7% are unsupported by this paper. (LLM, conf=0.87)
Experimental — accuracy not yet measuredDiabetes has been repeatedly associated with an increased risk of C. auris systemic infection.
“diabetes has also been repeatedly associated with an increased risk of C. auris systemic infection [15,40–43].”
From Host–Candida auris interactions in the skin (2026) · cites this paper as [43]
The Discussion (page not supplied) says diabetes can suppress immune function and make patients vulnerable to fungal infections such as C. auris. The Results (page not supplied) report diabetes in 27.1% of cases, but the study does not establish an increased risk specifically of systemic infection or document a repeated association; 57% of its cases were colonized. (LLM, conf=0.84)
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Cites
Diabetic Kidney Disease: Challenges, Progress, and Possibilities
Alicic, R. Z., Rooney, M. T., & Tuttle, K. R. (2017) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.11491116 · Cited by 2,898 · see citing works
<i>Candida auris</i> Outbreak in a COVID-19 Specialty Care Unit — Florida, July–August 2020
Prestel, C., Anderson, E., Forsberg, K., Lyman, M., de Perio, M. A., Kuhar, D., Edwards, K., Rivera, M., Shugart, A., Walters, M., et al. (2021) · MMWR. Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm7002e3 · Cited by 237 · see citing works
Chen, J., Tian, S., Han, X., Chu, Y., Wang, Q., Zhou, B., & Shang, H. (2020) · BMC Infectious Diseases · doi:10.1186/s12879-020-05543-0 · Cited by 159 · see citing works
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Research works printed but not linked: 12
- [2]Antibiotic resistance threats in the United States, 2019. Centers for Disease Control and Prevention, Atlanta, GA. (2019) 10.15620/cdc:82532. · DOI · Paper page
- [3]Satoh K Makimura K Hasumi Y Nishiyama Y Uchida K Yamaguchi H Candida auris sp. nov., a novel ascomycetous yeast isolated from the external ear canal of an inpatient in a Japanese hospital Microbiol Immunol 2009 53 41 44 10.1111/j.1348-421.2008.00083.x 19161556 · DOI
- [6]Vatanshenassan M Boekhout T Meis JF Berman J Chowdhary A Ben- Ami R Candida auris identification and rapid antifungal susceptibility testing against echinocandins by MALDI-TOF MS Front Cell Infect Microbiol 2019 9 20 10.3389/fcimb.2019.00020 30834236 PMC6387932 · DOI
- [7]Munoz JF Gade L Chow NA Loparev VN Juieng P Berkow EL Genomic insights into multidrug-resistance, mating and virulence in Candida auris and related emerging species Nat Commun 2018 9 1 5346 10.1038/s41467-018-07779-6 30559369 PMC6297351 · DOI · Paper page
- [8]Jeffery-Smith A Taori SK Schelenz S Jeffery K Johnson EM Borman A Candida auris: a review of the literature Clin Microbiol Rev 2018 31 e00029 e117 10.1128/CMR.00029-17 29142078 PMC5740969 · DOI
- [9]Meis JF Chowdhary A Candida auris: a global fungal public health threat Lancet Infect Dis 2018 18 1298 1299 10.1016/S1473-3099(18)30609-1 30293876 · DOI
- [10]Public health issues with Candida auris in COVID‐19 patients. World Med Health Policy 2021;13(4):766–72. 10.1002/wmh3.472 PMC8661744 34909239 · DOI
- [11]Asadzadeh M Mokaddas E Ahmad S Abdullah A Molecular characterisation of Candida auris isolates from immunocompromised patients in a tertiary-care hospital in Kuwait reveals a novel mutation in FKS1 conferring reduced susceptibility to echinocandins Mycoses 2022 65 3 331 343 10.1111/myc.13419 34953089 · DOI · Paper page
- [12]Southwick K Ostrowsky B Greenko J Adams E Lutterloh E A description of the first Candida auris-colonized individuals in New York State 2016–2017 Am J Infect Control 2022 50 3 358 360 10.1016/j.ajic.2021.10.037 34793894 PMC9853438 · DOI
- [13]Chowdhary A Tarai B Singh A Multidrug-resistant Candida auris infections in critically ill coronavirus disease patients, India, April–July 2020 Emerg Infect Dis 2020 26 2694 2696 10.3201/eid2611.203504 32852265 PMC7588547 · DOI
- [15]Price TK Mirasol R Ward KW Emergence of clade III Candida auris of African origin in Los Angeles medRxiv 2020 10.1101/2020.10.26.20214908 · DOI
- [18]Rhee CM Ahmadi SF Kovesdy CP Kalantar-Zadeh K Low-protein diet for conservative management of chronic kidney disease: a systematic review and meta-analysis of controlled trials J Cachexia Sarcopenia Muscle 2018 9 235 245 10.1002/jcsm.12264 29094800 PMC5879959 · DOI
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Sorted by citations
Host–Candida auris interactions in the skin
Thangamani, S., Balakumar, A., Datta, A., Bryak, G., & Lionakis, M. S. (2026) · PLOS Pathogens · doi:10.1371/journal.ppat.1014075 · Cited by 3 · see citing works
- Authors
- Amer, H. A., AlFaraj, S., Alboqami, K., Alshakarh, F., Alsalam, M., Kumar, D., Altayieb, J., Alsunid, A., Khanum, N., Dar, N. G., Badawi, M., Abdallah, H., & Memish, Z. A.
- Affiliations
- King Saud Medical City (SA)
- Alfaisal University (SA)
- Corresponding author
- Amer, Hala A.
- Venue
- Journal of Epidemiology and Global Health
- Published
- 2023-10-23
- Volume
- 13
- Issue
- 4
- Pages
- 825-830
- ISSN
- 2210-6006 (ISSN-L)
- 2210-6014
- PMC
- PMC10686928
- OpenAlex
- W4387865183
- Cited by
- 18
- References
- 3
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 4
- FWCI
- 3.73
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Journal of Epidemiology and Global Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
- Keywords
- Candida auris, fungemia, infection control, mortality risk factors, Foley catheter, vascular catheters, mechanical ventilation, comorbidities, active screening, infection prevention bundle, Saudi Arabia, COVID-19 comorbidity, antibiotic use, tracheostomy, endotracheal tube
- MeSH terms
- Candida, Female, Hospitals, Humans, Male, Retrospective Studies, Saudi Arabia, Candidiasis, Invasive
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