Progression from Candida auris Colonization Screening to Clinical Case Status, United States, 2016–2023
Open accessAbstract
During 2016-2023, among 21,195 US patients who tested positive for Candida auris colonization, 6.9% were subsequently found to have a positive clinical specimen (2.8% from blood). Strategies are needed to prevent invasive C. auris infections among patients with colonization (e.g., through patient decolonization).
AI snapshot
Written from the paper’s full text.
TL;DR
Among 21,195 US patients with positive *Candida auris* colonization screening during 2016–2023, 6.9% subsequently had a positive clinical specimen, including 2.8% from blood. The authors conclude that invasive *C. auris* infections, especially candidemia, can follow colonization and that prevention strategies such as decolonization need further study.
Key findings
- Of 21,195 patients with positive *C. auris* screening results, 1,458 (6.9%) had a screening-to-clinical (StC) event; 2.8% involved blood and 4.1% involved nonblood specimens.
- The percentage with an StC event rose from 0.0% (0/13) in 2016 to 9.9% (129/1,299) in 2020, then fell to 4.9% (365/7,493) in 2023.
- Among StC events, blood (40.1%, n=584) and urine (26.8%, n=391) were the most common body sites; median time from screening to clinical specimen was longest for blood (58 days, IQR 22–130).
- StC frequency varied by region (p<0.001) and facility type (p<0.001), being highest in the West (13.6%) and in long-term acute care hospitals (10.4%).
Methods
- Analysis of US national case-based surveillance data reported to CDC by state and jurisdictional health departments during 2016–2023; *C. auris* is nationally notifiable but reporting mandates vary.
- Screening cases were positive laboratory results from colonization swabs, usually composite axilla/groin; clinical cases were positive results from clinical specimens. Patients with a clinical case >1 calendar day after screening were considered StC events.
- The study calculated total and annual percentages of screening patients with StC events, described StC events by body site, and compared characteristics using χ2 tests for categorical data and Kruskal-Wallis rank-sum tests for continuous data (α=0.05).
Limitations
- The paper states the study likely underestimates progression because of missed screening opportunities, culture insensitivity, clinical laboratories not routinely distinguishing *C. auris* from other *Candida* species for nonsterile specimens, and incomplete 2024 data.
- The paper states it lacked data on previous negative screening results, differentiation between infection and colonization, and underlying patient conditions.
- The text makes evident additional constraints: reporting mandates varied across jurisdictions, and data were missing for age (n=17,928), sex (n=16,446), and facility type (n=17,357).
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
11 of 14 cited sources checked · 5 supported · 0 flagged · accuracy not yet measured
- Premisecitation
Clinical laboratories might not routinely distinguish C. auris from other Candida species for nonsterile specimen types, so StC events could have been missed.
“StC events could have been missed because of missed screening opportunities, the insensitivity of culture (9), treating clinical laboratories that might not routinely distinguish C. auris from other Candida species for nonsterile specimen types (10), and the fact that US C. auris data from 2024 are not finalized, meaning some patients might not have had sufficient lead time for clinical cases to”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [10] Keighley, 2021, Candida auris: diagnostic challenges and emerging opportunities for the clinical microbiology laboratory., Curr Fungal Infect Rep source
- Interpretationcitation
The 6.9% progression in this study is comparable to the 3.7% bloodstream infection rate in a New York state study.
“This finding is comparable with a smaller New York state study in which a C. auris bloodstream infection occurred in 7/187 (3.7%) colonized patients (median time from screening case testing to infection 86 days) (7).”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [7] Southwick, 2018, New York state 2016–2018: progression from Candida auris colonization to bloodstream infection., Open Forum Infect Dis source
- Findingown data
StC events were most frequent for patients with screening specimens collected in LTACHs (10.4%), followed by ACHs (5.9%), ventilator-capable SNFs (5.2%), non-ventilator-equipped SNFs (2.7%), and other facility types (1.9%).
“StC events were most frequent for patients with screening specimens collected in LTACHs (10.4%), then ACHs (5.9%), ventilator-capable SNFs (5.2%), non–ventilator-equipped SNFs (2.7%), and other facility types (1.9%).”
Quote in the paperNot a substantial claim - Findingown data
Among women with StC events, blood specimens were approximately twice as common as urine (42.6% vs. 21.5%).
“Among women, blood specimens were approximately twice as common as urine (42.6% vs. 21.5%), whereas among men, the percentage was similar (32.0% vs. 32.2%).”
Quote in the paperNot a substantial claim - Findingown data
StC event frequency varied significantly by region (p < 0.001).
“StC event frequency was similar by age (p = 0.650) and sex (p = 0.478) and varied by region (p<0.001), and facility type (p<0.001).”
Quote in the paperNot a substantial claim
- Findingown data
Among patients with positive C. auris screening in the United States during 2016-2023, 2.8% had a clinical specimen from blood.
“During 2016–2023, among 21,195 US patients who tested positive for Candida auris colonization, 6.9% were subsequently found to have a positive clinical specimen (2.8% from blood).”
- Also stated in: § The Study · plain
“During 2016–2023, a total of 36 of 40 reporting jurisdictions reported 21,195 patients who had a positive screening result; of those, 1,458 (6.9%) patients across 22 jurisdictions had an StC event (2.8% blood, 4.1% nonblood) (Table 1).”
Quote in the paperSubstantial claim - Also stated in: § The Study · plain
- Findingown data
Among StC events, blood (40.1%) and urine (26.8%) were the most common body sites.
“Among StC events (n = 1,458), blood (40.1%, n = 584) and urine (26.8%, n = 391) were most common (Table 2); the distribution of affected body sites was generally similar across years (Appendix Figure).”
Quote in the paperNot a substantial claim - Findingown data
The distribution of affected body sites among StC events was generally similar across years.
“Among StC events (n = 1,458), blood (40.1%, n = 584) and urine (26.8%, n = 391) were most common (Table 2); the distribution of affected body sites was generally similar across years (Appendix Figure).”
Quote in the paperNot a substantial claim - Findingown data
StC event frequency did not differ significantly by sex (p = 0.478).
“StC event frequency was similar by age (p = 0.650) and sex (p = 0.478) and varied by region (p<0.001), and facility type (p<0.001).”
- Also stated in: § The Study · plain
“StC event frequency was similar between women (7.4%) and men (7.1%) and was greatest among patients with screening specimens collected in the West (13.6%), Northeast (8.5%), Mid-Atlantic (4.3%), or Mountain (4.3%) regions.”
Quote in the paperNot a substantial claim - Also stated in: § The Study · plain
- Findingown data
Regardless of the facility type where the screening case was detected, most StC events were detected in an LTACH (45.6%) or ACH (46.0%).
“Regardless of the facility type where the screening case was detected, most StC events were detected in an LTACH (45.6%) or ACH (46.0%).”
Quote in the paperNot a substantial claim - Findingown data
The most common facility types of initial screening case detection were LTACHs (62.2%) and ACHs (20.5%).
“The most common facility types of initial screening case detection were LTACHs (62.2%) and ACHs (20.5%) (Figure 2).”
Quote in the paperNot a substantial claim - Findingown data
The percentage of patients with an StC event peaked in 2020 then declined.
“The percentage of patients with an StC event peaked in 2020 then declined, potentially because of improved infection prevention and control efforts or increased screening after COVID-19–related resource strains resolved.”
Quote in the paperSubstantial claim - Findingown data
The West had a relatively low percentage of clinical cases involving blood.
“The volume of screening cases and frequency of clinical cases was greatest in the West, but the region had a relatively low percentage of clinical cases involving blood; that finding might reflect regional differences in case reporting and in testing practices for C. auris in noninvasive body sites (8).”
Quote in the paperSubstantial claim - Findingown data
StC event frequency was highest in the West region (13.6%).
“StC event frequency was similar between women (7.4%) and men (7.1%) and was greatest among patients with screening specimens collected in the West (13.6%), Northeast (8.5%), Mid-Atlantic (4.3%), or Mountain (4.3%) regions.”
Quote in the paperNot a substantial claim - Findingown data
During 2016-2023, among 21,195 US patients who tested positive for Candida auris colonization, 6.9% subsequently had a positive clinical specimen (screening-to-clinical event).
“During 2016–2023, among 21,195 US patients who tested positive for Candida auris colonization, 6.9% were subsequently found to have a positive clinical specimen (2.8% from blood).”
- Also stated in: § The Study · plain
“During 2016–2023, a total of 36 of 40 reporting jurisdictions reported 21,195 patients who had a positive screening result; of those, 1,458 (6.9%) patients across 22 jurisdictions had an StC event (2.8% blood, 4.1% nonblood) (Table 1).”
Quote in the paperSubstantial claim - Also stated in: § The Study · plain
- Findingown data
More than half of clinical cases involving blood were detected 2 months after screening case detection.
“This analysis of national C. auris case data revealed that, among 21,195 patients who tested positive for C. auris on a colonization screening swab during 2016–2023, a clinical case subsequently occurred in 6.9% (2.8% involving blood); more than half of clinical cases involving blood were detected 2 months after screening case detection.”
Quote in the paperSubstantial claim - Findingown data
StC event frequency varied significantly by facility type (p < 0.001).
“StC event frequency was similar by age (p = 0.650) and sex (p = 0.478) and varied by region (p<0.001), and facility type (p<0.001).”
Quote in the paperNot a substantial claim - Findingown data
The number of patients with C. auris screening cases increased each year during 2016-2023.
“The number of patients with screening cases increased each year, and the percentage of those with an StC event increased from 0.0% (0/13) in 2016 to 9.9% (129/1,299) in 2020, then decreased to 4.9% (365/7,493) in 2023 (Figure 1).”
Quote in the paperNot a substantial claim - Findingown data
StC event frequency did not differ significantly by age (p = 0.650).
“StC event frequency was similar by age (p = 0.650) and sex (p = 0.478) and varied by region (p<0.001), and facility type (p<0.001).”
Quote in the paperNot a substantial claim - Findingown data
The most common regions of screening case specimen collection were the West (31.2%), Midwest (20.1%), and Southeast (20.0%).
“The most common regions of screening case specimen collection were the West (31.2%, n = 6,617), Midwest (20.1%, n = 4,264), and Southeast (20.0%, n = 4,235) and the most common facility types among those with known facility type (n = 17,357) were LTACH (50.2%, n = 8,716), acute care hospital (ACH) (29.0%, n = 5,033), and ventilator-capable SNF (16.8%, n = 2,912).”
Quote in the paperNot a substantial claim - Interpretationreasoning
StC events could have been missed because of missed screening opportunities.
“StC events could have been missed because of missed screening opportunities, the insensitivity of culture (9), treating clinical laboratories that might not routinely distinguish C. auris from other Candida species for nonsterile specimen types (10), and the fact that US C. auris data from 2024 are not finalized, meaning some patients might not have had sufficient lead time for clinical cases to”
Quote in the paperSubstantial claim - Interpretationreasoning
The study likely underestimates the actual percentage of patients with C. auris colonization who progress to having a clinical case.
“For several reasons, we suspect that our study underestimates the actual percentage of patients with C. auris colonization who progress to having a clinical case.”
Quote in the paperSubstantial claim - Study design and conductown data
The analysis included 21,195 patients with positive C. auris screening results reported by 36 of 40 jurisdictions during 2016-2023.
“During 2016–2023, a total of 36 of 40 reporting jurisdictions reported 21,195 patients who had a positive screening result; of those, 1,458 (6.9%) patients across 22 jurisdictions had an StC event (2.8% blood, 4.1% nonblood) (Table 1).”
Quote in the paperSubstantial claim - Interpretationown data
Patients colonized with C. auris are at potential for C. auris infections, particularly candidemia.
“Overall, our study highlights the potential for C. auris infections, particularly candidemia, among patients colonized with C. auris.”
Quote in the paperSubstantial claim
- Classified as probably not a substantial claim. 12
- May combine two claims. 13
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationCDC recommends colonization screening for patients with high-risk healthcare exposures and those with an epidemiologic link to a patient with C. auris.
“Because C. auris spreads easily in healthcare settings, the Centers for Disease Control and Prevention (CDC) recommends colonization screening for patients with high-risk healthcare exposures (e.g., recent stay in a long-term acute-care hospital [LTACH] or ventilator-capable skilled nursing facility [SNF]) and those with an epidemiologic link to a patient with C. auris (2,6) (https://www.cdc.gov/c”
Quote in the paperNot a substantial claim2 of 2 sources checked- cites [2] Pacilli, 2020, Regional emergence of Candida auris in Chicago and lessons learned from intensive follow-up at 1 ventilator-capable skilled nursing facility., Clin Infect Dis source
The Methods (Active Surveillance and Infection-Control Assessments in Chicago; page unavailable) describe C. auris colonization screening at facilities selected because they had housed a case-patient. The Results (Illinois Surveillance; page unavailable) identify recent LTACH or vSNF residence as common among clinical cases. Our copy does not state that CDC recommends screening patients with those exposures or epidemiologic links; it describes Chicago's surveillance practice instead. (LLM, conf=0.83)
Experimental — accuracy not yet measured - cites [6] McKinnell, 2019, The SHIELD Orange County Project: multidrug-resistant organism prevalence in 21 nursing homes and long-term acute care facilities in southern California., Clin Infect Dis source
The Methods passage describes screening nursing-home and long-term acute-care residents for MRSA, VRE, ESBL-producing organisms, and CRE. Searches for C. auris, epidemiologic links, and CDC screening recommendations found no passage addressing the claimed guidance. (LLM, conf=0.76)
Experimental — accuracy not yet measured
Classified as probably not a substantial claim.
PremisecitationC. auris spreads easily in healthcare settings.
“Because C. auris spreads easily in healthcare settings, the Centers for Disease Control and Prevention (CDC) recommends colonization screening for patients with high-risk healthcare exposures (e.g., recent stay in a long-term acute-care hospital [LTACH] or ventilator-capable skilled nursing facility [SNF]) and those with an epidemiologic link to a patient with C. auris (2,6) (https://www.cdc.gov/c”
Quote in the paperSubstantial claim2 of 2 sources checked- cites [2] Pacilli, 2020, Regional emergence of Candida auris in Chicago and lessons learned from intensive follow-up at 1 ventilator-capable skilled nursing facility., Clin Infect Dis source
- cites [6] McKinnell, 2019, The SHIELD Orange County Project: multidrug-resistant organism prevalence in 21 nursing homes and long-term acute care facilities in southern California., Clin Infect Dis source
The Abstract says multidrug-resistant organisms spread between healthcare facilities through patient transfers, but it identifies the organisms studied as MRSA, VRE, ESBL-producing organisms, and CRE. A search for “C. auris” and “Candida auris” found no passage addressing whether that organism spreads easily in healthcare settings. Page numbers were not available in our copy. (LLM, conf=0.76)
Experimental — accuracy not yet measured
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationPatients colonized with C. auris can progress to having invasive infections, which are associated with crude mortality rates of 30%-72%.
“Patients colonized with C. auris can progress to having invasive infections, which are associated with crude mortality rates of 30%–72% (4,5).”
Quote in the paperNot a substantial claim1 of 2 sources checked- cites [4] Lockhart, 2017, Simultaneous emergence of multidrug-resistant Candida auris on 3 continents confirmed by whole-genome sequencing and epidemiological analyses., Clin Infect Dis source
The Results report in-hospital deaths among patients with C. auris infection, ranging from 33% to 72% by country, and 68% mortality among those with bloodstream infections. The paper does not report that patients known to be colonized subsequently progressed to invasive infection; its reported mortality rates also include patients whose infections were not bloodstream infections. (LLM, conf=0.84)
Experimental — accuracy not yet measured - cites [5] Chakrabarti, 2015, Incidence, characteristics and outcome of ICU-acquired candidemia in India., Intensive Care Med source
May combine two claims.
PremisecitationIn a New York state study, a C. auris bloodstream infection occurred in 7/187 (3.7%) colonized patients, with median time from screening case testing to infection 86 days.
“This finding is comparable with a smaller New York state study in which a C. auris bloodstream infection occurred in 7/187 (3.7%) colonized patients (median time from screening case testing to infection 86 days) (7).”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [7] Southwick, 2018, New York state 2016–2018: progression from Candida auris colonization to bloodstream infection., Open Forum Infect Dis source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationCandida auris can colonize patients asymptomatically and persist on skin for months to years without causing infection.
“Candida auris, an emerging, frequently antifungal-resistant yeast, can colonize patients asymptomatically and persist on skin for months to years without causing infection (1–3).”
Quote in the paperNot a substantial claim3 of 3 sources checked- cites [1] Lyman, 2023, Worsening spread of Candida auris in the United States, 2019 to 2021., Ann Intern Med source
The Methods (Data Sources; page unavailable) distinguish clinical cases from colonization-screening cases identified by positive skin swabs, supporting the point that C. auris can colonize skin without being identified as an infection. The paper does not state that such colonization is asymptomatic or persists for months to years. (LLM, conf=0.82)
Experimental — accuracy not yet measured - cites [2] Pacilli, 2020, Regional emergence of Candida auris in Chicago and lessons learned from intensive follow-up at 1 ventilator-capable skilled nursing facility., Clin Infect Dis source
The Methods describe skin-swab surveillance for colonization, and the Results explicitly refer to asymptomatically colonized individuals. The Results and Discussion document persistent colonization during repeated surveys from January to October 2018, but do not establish persistence for years without infection. (LLM, conf=0.86)
Experimental — accuracy not yet measured - cites [3] Arenas, 2024, Persistent colonization of Candida auris among inpatients rescreened as part of a weekly surveillance program., Infect Control Hosp Epidemiol source
Probably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataAmong men with StC events, blood and urine specimens were similar in frequency (32.0% vs. 32.2%).
“Among women, blood specimens were approximately twice as common as urine (42.6% vs. 21.5%), whereas among men, the percentage was similar (32.0% vs. 32.2%).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataBody sites of clinical cases varied significantly by age (p = 0.023), sex (p < 0.001), region (p < 0.001), and time from screening to clinical specimen collection (p = 0.001).
“Body sites of clinical cases varied by age (p = 0.023), sex (p<0.001), region (p<0.001), and time from screening case to clinical case specimen collection (p = 0.001) (Table 2).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataThe volume of screening cases and frequency of clinical cases was greatest in the West.
“The volume of screening cases and frequency of clinical cases was greatest in the West, but the region had a relatively low percentage of clinical cases involving blood; that finding might reflect regional differences in case reporting and in testing practices for C. auris in noninvasive body sites (8).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataThe median number of days from initial screening to clinical specimen was longest for blood (58 days, IQR 22-130) and shortest for respiratory (33 days, IQR 17-74) and other (28 days, IQR 14-77) specimen types.
“The median number of days from initial screening case specimen to clinical specimen was longest for blood (58, IQR 22–130, range 1–1,309 days) and shortest for respiratory (33, IQR 17–74, range 1–1,240 days) and other (28, IQR 14–77, range 1–745 days) specimen types.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataThe percentage of patients with an StC event increased from 0.0% in 2016 to 9.9% in 2020, then decreased to 4.9% in 2023.
“The number of patients with screening cases increased each year, and the percentage of those with an StC event increased from 0.0% (0/13) in 2016 to 9.9% (129/1,299) in 2020, then decreased to 4.9% (365/7,493) in 2023 (Figure 1).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataBlood specimens constituted most StC events in the Southeast (58.9%), Northeast (58.6%), and Mid-Atlantic (57.8%) regions but less than half in other regions.
“Blood specimens constituted most StC events in the Southeast (58.9%), Northeast (58.6%), and Mid-Atlantic (57.8%) regions but less than half of specimens in other regions.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingown dataAmong patients with screening cases and known sex, 57.4% were men and 42.6% were women.
“Among patients with screening cases (n = 21,195), the median age was 68 (interquartile range [IQR] 58–76) years; of those with known sex (n = 16,446), 9,448 (57.4%) were men and 6,998 (42.6%) were women (Table 1).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataAmong patients with screening cases, the median age was 68 years (IQR 58-76).
“Among patients with screening cases (n = 21,195), the median age was 68 (interquartile range [IQR] 58–76) years; of those with known sex (n = 16,446), 9,448 (57.4%) were men and 6,998 (42.6%) were women (Table 1).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataThe most common facility types among those with known facility type were LTACH (50.2%), acute care hospital (29.0%), and ventilator-capable SNF (16.8%).
“The most common regions of screening case specimen collection were the West (31.2%, n = 6,617), Midwest (20.1%, n = 4,264), and Southeast (20.0%, n = 4,235) and the most common facility types among those with known facility type (n = 17,357) were LTACH (50.2%, n = 8,716), acute care hospital (ACH) (29.0%, n = 5,033), and ventilator-capable SNF (16.8%, n = 2,912).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable). May combine two claims.
InterpretationreasoningThe peak in 2020 and subsequent decline in StC event percentage may be due to improved infection prevention and control efforts or increased screening after COVID-19-related resource strains resolved.
“The percentage of patients with an StC event peaked in 2020 then declined, potentially because of improved infection prevention and control efforts or increased screening after COVID-19–related resource strains resolved.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
InterpretationcitationThe relatively low percentage of blood clinical cases in the West might reflect regional differences in case reporting and in testing practices for C. auris in noninvasive body sites.
“The volume of screening cases and frequency of clinical cases was greatest in the West, but the region had a relatively low percentage of clinical cases involving blood; that finding might reflect regional differences in case reporting and in testing practices for C. auris in noninvasive body sites (8).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [8] Lockhart, 2017, Thinking beyond the common Candida species: need for species-level identification of Candida due to the emergence of multidrug-resistant Candida auris., J Clin Microbiol source
May combine two claims.
PremisecitationCulture for C. auris is insensitive, so StC events could have been missed.
“StC events could have been missed because of missed screening opportunities, the insensitivity of culture (9), treating clinical laboratories that might not routinely distinguish C. auris from other Candida species for nonsterile specimen types (10), and the fact that US C. auris data from 2024 are not finalized, meaning some patients might not have had sufficient lead time for clinical cases to”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [9] Clancy, 2013, Finding the “missing 50%” of invasive candidiasis: how nonculture diagnostics will improve understanding of disease spectrum and transform patient care., Clin Infect Dis source
May combine two claims.
Study design and conductreasoningUS C. auris data from 2024 were not finalized, so some patients might not have had sufficient lead time for clinical cases to occur.
“StC events could have been missed because of missed screening opportunities, the insensitivity of culture (9), treating clinical laboratories that might not routinely distinguish C. auris from other Candida species for nonsterile specimen types (10), and the fact that US C. auris data from 2024 are not finalized, meaning some patients might not have had sufficient lead time for clinical cases to”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenData from 2023 were unavailable from 1 state in the Central region.
“Data from 2023 were unavailable from 1 state in the Central region.”
Quote in the paperNot a substantial claimMay combine two claims.
Study design and conductown dataFor clinical cases, the analysis lacked data on previous negative screening results, differentiation between infection and colonization, and underlying patient conditions.
“In addition, for clinical cases, we lacked data on previous negative screening results, the differentiation between infection and colonization, and underlying patient conditions.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataData on days from screening to clinical specimen was missing for 1 patient with a clinical case involving a wound.
“#Data missing for 1 patient with a clinical case involving a wound.”
Quote in the paperNot a substantial claim
The paper relies on this without support.
Data characterizing the progression from C. auris colonization to invasive disease are limited.
“Data characterizing the progression from C. auris colonization to invasive disease are limited but might help guide public health surveillance, prevention, and treatment efforts.”
The paper relies on this without support.
Reporting mandates for C. auris vary across states and jurisdictions.
“C. auris is a nationally notifiable condition, but reporting mandates vary across states and jurisdictions.”
The paper relies on this without support.
C. auris is a nationally notifiable condition.
“C. auris is a nationally notifiable condition, but reporting mandates vary across states and jurisdictions.”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Table 1 test footnote conflicts with the stated continuous-data method
MinorTable 1 includes a p value for median age, a continuous characteristic, but its footnote says p values were calculated using χ2 tests. The methods instead specify Kruskal-Wallis tests for continuous data.
“†p values were calculated using χ2 tests to compare characteristics of patients with a C. auris screening case who had (vs. did not have) progression to a C. auris clinical case.”
“We analyzed categorical data using χ2 tests and continuous data using Kruskal-Wallis rank-sum tests (α = 0.05).”
Sex counts for patients with clinical cases differ between tables
MinorTable 1 reports 668 men and 515 women with a clinical case, whereas Table 2 reports 671 men and 512 women for the same 1,183 patients with known sex.
“| M | 9,448 | 668 (7.1) | 8,780 (92.9) | | | F | 6,998 | 515 (7.4) | 6,483 (92.6) | |”
“| M | 671 | 215 (32.0) | 216 (32.2) | 124 (18.5) | 76 (11.3) | 40 (6.0) | | | F | 512 | 218 (42.6) | 110 (21.5) | 84 (16.4) | 73 (14.3) | 27 (5.3) | |”
One-day intervals conflict with the StC event definition
MinorAn StC event requires the clinical case to occur more than one calendar day after screening, but Table 2 reports a minimum interval of one day.
“We considered patients with the corresponding clinical case >1 calendar day after a screening case to have a screening-to-clinical (StC) event.”
“| Minimum–maximum | 1–1,597 | 1–1,309 | 1–1,597 | 1–1,240 | 1–666 | 1–745 | |”
Cites
Lockhart, S. R., Etienne, K. A., Vallabhaneni, S., Farooqi, J., Chowdhary, A., Govender, N. P., Colombo, A. L., Calvo, B., Cuomo, C. A., Desjardins, C. A., et al. (2017) · Clinical Infectious Diseases · doi:10.1093/cid/ciw691 · Cited by 1,662 · see citing works
Clancy, C. J., & Nguyen, M. H. (2013) · Clinical Infectious Diseases · doi:10.1093/cid/cit006 · Cited by 688 · cited 1× · see citing works
“StC events could have been missed be - cause of missed screening opportunities, the insensitivity of culture ( 9 ), treating clinical laboratories that might not routinely distinguish C. auris from other Candida species for nonsterile specimen types ( 10 ), and the fact that US C. auris data from…”
Incidence, characteristics and outcome of ICU-acquired candidemia in India
Chakrabarti, A., Sood, P., Rudramurthy, S. M., Chen, S., Kaur, H., Capoor, M., Chhina, D., Rao, R., Eshwara, V. K., Xess, I., et al. (2015) · Intensive Care Medicine · doi:10.1007/s00134-014-3603-2 · Cited by 454 · see citing works
Worsening Spread of <i>Candida auris</i> in the United States, 2019 to 2021
Lyman, M., Forsberg, K., Sexton, D. J., Chow, N. A., Lockhart, S. R., Jackson, B. R., & Chiller, T. (2023) · Annals of Internal Medicine · doi:10.7326/m22-3469 · Cited by 287 · see citing works
Self-citationPacilli, M., Kerins, J. L., Clegg, W. J., Walblay, K. A., Adil, H., Kemble, S. K., Xydis, S., McPherson, T. D., Lin, M. Y., Hayden, M. K., et al. (2020) · Clinical Infectious Diseases · doi:10.1093/cid/ciaa435 · Cited by 103 · see citing works
Self-citationKeighley, C., Garnham, K., Harch, S. A. J., Robertson, M., Chaw, K., Teng, J. C., & Chen, S. C.-A. (2021) · Current Fungal Infection Reports · doi:10.1007/s12281-021-00420-y · Cited by 87 · see citing works
McKinnell, J. A., Singh, R. D., Miller, L. G., Kleinman, K., Gussin, G., He, J., Saavedra, R., Dutciuc, T. D., Estevez, M., Chang, J., et al. (2019) · Clinical Infectious Diseases · doi:10.1093/cid/ciz119 · Cited by 76 · see citing works
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Arenas, S. P., Persad, P. J., Patel, S., Parekh, D. J., Ferreira, T. B. D., Farinas, M., Sexton, D. J., Lyman, M., Gershengorn, H. B., & Shukla, B. S. (2024) · Infection Control & Hospital Epidemiology · doi:10.1017/ice.2023.251 · Cited by 21 · see citing works
Self-citation
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- Authors
- Baker, A. D., Gold, J. A. W., Forsberg, K., Jones, S., & Lyman, M. M.
- Venue
- Emerging Infectious Diseases
- Published
- 2025-08
- Volume
- 31
- Issue
- 8
- Pages
- 1613-1617
- ISSN
- 1080-6040 (ISSN-L)
- 1080-6059
- PMC
- PMC12309774
- OpenAlex
- W4412633162
- Semantic Scholar
- 0d737165689568b60694a31956daa4ec114f97a1
- Cited by
- 27
- References
- 10
- Citations by year
- 2026: 23 · 2025: 4
- FWCI
- 18.91
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by
- Locations
- Emerging infectious diseases (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (submittedVersion, cc-by)
- PubMed Central (submittedVersion, cc-by)
- 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 › Epidemiology › Fungal Infections and Studies
- Keywords
- Candida auris, colonization, invasive candidiasis, blood culture, fungal infection prevention, screening
- MeSH terms
- Candida auris, Adult, Aged, Candida, Candidiasis, Female, Humans, Male, Mass Screening, Middle Aged, United States, History, 21st Century, Young Adult
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-21.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-21.
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