Understanding the epidemiology of Candidozyma auris: a case-control study at an acute hospital in London, UK.

INTRODUCTION

Candidozyma auris (formerly Candida auris) is an emerging cause of healthcare-associated infection with increasing global prevalence and significant clinical implications. Since September 2023, an outbreak of C. auris occurred at a London National Health Service Trust, prompting a retrospective case-control study to identify risk factors for colonisation or infection.

METHODS

We conducted a matched case-control study of patients tested for C. auris between October 2023 and July 2024. Cases (N=76) were matched in a ratio of 1:2 with controls (N=152) by speciality, age group, and sex. Data on demographics, comorbidities, procedures, and antimicrobial use were extracted from electronic health records. Logistic regression was used to identify independent risk factors.

RESULTS

C. auris colonisation was associated with longer hospital stay prior to testing (odds ratio [OR]: 1.02/day), hypertension (OR: 2.9), osteomyelitis (OR: 10.0), Doppler probe use (OR: 3.8), and exposure to antibacterials (OR: 8.4). No significant associations were found with indwelling devices. Colonisation was not linked to increased mortality or length of stay.

DISCUSSION: Our findings highlight the importance of environmental hygiene and early screening. Doppler probe use emerged as a potential vector for transmission. These results support targeted infection control measures and reinforce the value of proactive surveillance in managing C. auris outbreaks.