Candidozyma auris candidemia in critically ill patients: epidemiology, predictive factors and prognostic impact.

PURPOSE: To describe the epidemiology of Candidozyma auris (Candida auris) candidemia, identify its predictive factors, and evaluate its prognostic impact in critically ill patients.

METHODS

This retrospective study was conducted in the intensive care units (ICUs) of two tertiary hospitals. All adult patients with candidemia admitted between 01.01.2022, and 31.03.2024 were included. Two groups were compared: C. auris (CA) and non-Candidosyma auris (NCA) candidemia.

RESULTS

A total of 51 patients were included, of whom 27 (52.9 %) had C. auris candidemia. C. auris candidemia was significantly associated to higher rate of colonisation with carbapenem-resistant Enterobacteriales (51.9 vs 20.8 %; p= 0.022). Additionally, patients in the CA group were more frequently exposed to ceftazidime - avibactam (40.7 % vs 8.3 %; p = 0.008), tigecycline (44.4 % vs 12.5 %; p = 0.012), and antifungals (74.1 % vs 33.3 %; p = 0.004). multivariate analysis identified previous exposure to antifungals as the only independent predictor of C. auris candidemia (OR = 6.5 CI95 % [1.7-25.3]; p=0.007). Candidemia was associated with a higher incidence of septic shock (83.3 % vs 40.7 %; p=0.002), and increased need for mechanical ventilation (95.8 % vs 63 %; p=0.004) in patients with non-Candidosyma. auris fungemia.The 28-day mortality was 66.7 %, with no significant difference between CA and NCA groups (OR = 0.3 95 % CI [0.1-1.1]; p = 0.08).

CONCLUSION

Candidozyma auris has become the dominant isolate in our ICUs. Prior exposure to antifungals is the main predictive factor compared to NCA fungemia. Both CA and NCA exhibit similar 28-day mortality rates.