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Cited by 6Antifungal resistance and susceptibilityInfection Control in HealthcareFungal Infections and Studies

Risk Factors Associated With Progression to Clinical Candida auris Infection Among Adults With Previous Colonization—Florida, 2019–2023

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Saunders, Katharine E, Charles, Argentina, Doyle, Timothy J, Reyes, Juliana, Champlin, Gregory, Corral, Alina, Erskine, Jalysa, Hennessee, Ian +1 more·2026·Clinical Infectious Diseases
DOI 10.1093/cid/ciaf551PMC PMC13094817
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Abstract

BACKGROUND: Candida auris is an emerging fungal organism that has caused outbreaks in healthcare settings and become a major public health concern, particularly among medically vulnerable populations. METHODS: Using a retrospective case-control design, we investigated factors associated with C. auris clinical cases after prior colonization among patients identified in Florida healthcare facilities during 1 January 2019-31 December 2023. RESULTS: We identified 105 case-patients with documented clinical specimens after colonization and 578 control subjects with colonization only. Factors significantly associated with clinical cases included presence of ≥5 comorbid conditions (odds ratio [OR], 10.02 [95% confidence interval {CI}, 4.07-24.7]), ≥ 4 invasive devices (OR, 2.92 [95% CI, 1.70-5.03]), or ≥3 recent medical procedures (OR, 2.32 [95% CI, 1.19-4.55]). In addition, fully dependent care required for eating (OR, 2.80), mobility (OR, 2.15), and transferring (OR, 1.82) were associated with clinical case progression. CONCLUSIONS: We found a significant association with progression from screening colonization to clinical C. auris cases among patients with multiple comorbidities, invasive devices, recent invasive procedures, and poor functional status. Identifying risk factors for clinical progression of C. auris after colonization could enable facilities to implement efficient testing protocols and infection prevention and control measures to help prevent morbidity associated with invasive infections.

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  • Diabetes is an underlying condition among patients with C. auris skin colonization, identified in 52% of cases.

    “Surveillance studies across diverse geographical regions have identified diabetes as an underlying condition among patients with C. auris skin colonization (52% of cases) [37–39]”

    From Host–Candida auris interactions in the skin (2026) · cites this paper as [39]

    The paper’s background passage identifies diabetes among previously reported medical risk factors for C. auris colonization or infection. It does not report diabetes in 52% of patients with skin colonization; the 52.4% figure in the Results refers to neurologic conditions among patients who progressed to clinical infection. (LLM, conf=0.87)

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Research works printed but not linked: 25

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Authors
Saunders, K. E., Charles, A., Doyle, T. J., Reyes, J., Champlin, G., Corral, A., Erskine, J., Hennessee, I., & Blackmore, C.
Affiliations
  • Centers for Disease Control and Prevention (US)
  • Florida Department of Health (US)
Corresponding author
Saunders, Katharine E
ORCID
Venue
Clinical Infectious Diseases
Publisher
Oxford University Press (OUP)
Published
2025-10-02
Volume
82
Issue
4
Pages
e765-e772
ISSN
  • 1058-4838 (ISSN-L)
  • 1537-6591
DOI
10.1093/cid/ciaf551
PMC
PMC13094817
OpenAlex
W4414739809
Cited by
6
References
4
Citations by year
2026: 6
FWCI
4.62
Type
journal article
Language
en
Open access
Licence
public-domain
Locations
  • Clinical Infectious Diseases (publishedVersion, public-domain)
  • PubMed Central (publishedVersion, public-domain)
  • PubMed (publishedVersion)
Funders
Florida Department of Health
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
  • Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
  • Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
Keywords
Candida auris, clinical progression, fungal colonization, risk factors, comorbidities, invasive devices, functional status, nosocomial infections, infection control, Florida
MeSH terms
Candida auris, Adult, Aged, Aged, 80 and over, Candida, Candidiasis, Female, Florida, Humans, Male, Middle Aged, Retrospective Studies, Risk Factors, Case-Control Studies, Disease Progression, Candidiasis, Invasive

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