Candidozyma auris: A retrospective analysis of diagnostic challenges, antifungal susceptibility, and infection control measures.

Candidozyma auris (C. auris) is an emerging multidrug-resistant fungal pathogen that poses a serious public health threat due to diagnostic challenges, high antifungal resistance rates, and prolonged environmental persistence, which facilitate outbreaks in healthcare settings. This study aimed to evaluate the epidemiological characteristics, risk factors, identification methods, antifungal susceptibility profiles, and infection control measures associated with C. auris cases detected over a four-month period (October 2024-January 2025). Clinical, screening and environmental samples were analyzed. Clinical samples consisted of blood cultures, while screening samples included axillary swabs. Isolate identification was performed using VITEK 2 YST, the BD Phoenix system V7.51A, and VITEK MS PRIME. Antifungal susceptibility testing was performed using the Sensititre™ฏ YeastOne YO10 system. A total of 14 clinical cases were identified, along with two environmental isolates and four axillary screening isolates, one of which was associated with a clinical case. The mean age of clinical cases was 64.8 years (SD 29.2; range 15-95), and the mortality rate was 71.4%. According to the Centers for Disease Control and Prevention (CDC) tentative breakpoints, all clinical isolates were resistant to fluconazole. Amphotericin B minimum inhibitory concentration (MIC) values were 2 µg/mL in 50% of isolates. One isolate showed high MIC values for echinocandins (micafungin and anidulafungin >8 µg/mL). This study reports the first locally documented cases of C. auris in our center and was conducted as part of an ongoing surveillance program. It highlights the clinical and environmental burden of C. auris, underscores its resistance profile, and emphasizes the critical importance of accurate identification and stringent infection control measures. Although clinical cases have continued to occur at a decreasing frequency, no further C. auris has been detected in environmental samples after the implementation of the infection control protocol, suggesting sustained effectiveness in limiting environmental contamination.