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Cited by 5Antifungal resistance and susceptibilityFungal Infections and StudiesYeasts and Rust Fungi Studies

Risk factors and outcomes for invasive infection among patients colonized with Candidozyma auris: a case-control study

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Alowais, Shuroug A., Wali, Haytham A., bin Saleh, Khalid, Aldugiem, Rema, Alsaeed, Yara, Almutairi, Meshari, Almangour, Thamer A., Alsowaida, Yazed S. +1 more·2025·Antibiotics
DOI 10.3390/antibiotics14121206PMC PMC12729946
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Abstract

Background: Candidozyma auris has emerged globally as a multidrug-resistant pathogen with high rates of colonization and potential for invasive infection. Understanding the progression from colonization to infection and associated outcomes is limited. This study aimed to describe the characteristics and outcomes of C. auris-colonized patients and identify risk factors for progression to infection. Methods: We conducted a single-center retrospective case–control study of hospitalized patients with documented C. auris colonization at a tertiary care center (2018–2024). Cases were patients who progressed to a fungal infection (infection group), while controls remained colonized (colonized group). Demographics, comorbidities, device use, prior antimicrobial exposure, microbiologic characteristics, and outcomes were compared. Results: Among 334 C. auris-colonized patients, 44 (13.2%) progressed to infection. The median age was 66.4 years. Those in the infection group had higher Charlson Comorbidity Index (5.9 ± 3.1 vs. 4.79 ± 2.7, p = 0.0112) and were more likely to have central line (90.9% vs. 71.7%, p = 0.0067), mechanical ventilation (77.3% vs. 60.34%, p = 0.0306), parenteral nutrition (6.82% vs. 1.72%, p = 0.0395), and abdominal surgery (13.64% vs. 4.83%, p = 0.0217). In multivariate analysis, abdominal surgery was the only independent predictor of infection (OR 4.08; 95% CI 1.1–15.1; p = 0.03). In-hospital mortality was significantly higher in the infection group (65.9% vs. 33.1%, p < 0.0001). Conclusions: Approximately one in eight colonized patients developed C. auris infection. Recent abdominal surgery independently predicted progression, while infection was associated with higher mortality and prolonged hospitalization, underscoring the need for targeted prevention in high-risk patients.

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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 [38]

    The Results (§2.1; page unavailable) identify diabetes mellitus among patients with C. auris colonization. They do not report that 52% of skin-colonized patients had diabetes; the study also included colonization detected at non-skin sites and was conducted at a single center, not across diverse regions. (LLM, conf=0.84)

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Authors
Alowais, S. A., Wali, H. A., bin Saleh, K., Aldugiem, R., Alsaeed, Y., Almutairi, M., Almangour, T. A., Alsowaida, Y. S., & Bosaeed, M.
Affiliations
  • King Saud bin Abdulaziz University for Health Sciences (SA)
  • King Faisal University (SA)
  • College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh 14611, Saudi Arabia
  • University of Ha'il (SA)
Corresponding author
Alowais, Shuroug A.
ORCID
Venue
Antibiotics
Publisher
MDPI AG
Published
2025-12-01
Volume
14
Issue
12
Pages
1206
ISSN
2079-6382 (ISSN-L)
DOI
10.3390/antibiotics14121206
PMC
PMC12729946
OpenAlex
W4416859248
Cited by
5
References
4
Citations by year
2026: 5
FWCI
3.85
Type
journal article
Language
en
Open access
Licence
Locations
  • Antibiotics (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • PubMed Central (publishedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
King Abdullah International Medical Research Center (NRC22R/260/06)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
  • Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Yeasts and Rust Fungi Studies
Keywords
Candida auris, fungal colonization, invasive candidiasis, risk factors, abdominal surgery, central venous catheters, mechanical ventilation, parenteral nutrition, Charlson Comorbidity Index, in-hospital mortality, multidrug-resistant fungi, hospitalized patients

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