Epidemiology, length of stay, and survival outcomes of Candida auris infections in a tertiary care center in the greater detroit area.

OBJECTIVES

To investigate the epidemiology and clinical outcomes of Candida auris (C. auris), reclassified Candidozyma auris, in a Detroit tertiary care center, focusing on mortality, length of stay (LOS), glucose variability, and demographic factors.

SETTING

Inpatient admissions in a Detroit tertiary care center, June 2023-March 2025.

PATIENTS: Among 9,025 C. auris tests, 725 (8.03%) were positive. A subpopulation of 242 hospitalized patients was analyzed for outcomes.

METHODS

Clinical and demographic data, including infection status, mortality, and LOS, were analyzed. Glucose variability was assessed by the coefficient of variation. ANOVA and Kruskal-Wallis tests evaluated group differences, pairwise Z-tests compared mortality, and a competing-risks survival analysis estimated probabilities of discharge and in-hospital death.

RESULTS

Mortality was highest among colonized/infected patients (31.3%) and significantly associated with race (p = 0.0072) and ethnicity (p = 0.0069). High glucose variability (>190 mg/dL) was linked to increased mortality (27.63%) and prolonged LOS (46.14 days; p < 0.01). Infected patients had the longest LOS (67.9 days), followed by colonized/infected (39.9) and colonized-only (30.2; p < 0.001).

CONCLUSION

C. auris disproportionately affects African American patients and those with high glucose variability, contributing to higher mortality and longer hospitalization. Infection status and glycemic instability were the strongest predictors of LOS, while racial and ethnic disparities influenced mortality. Strengthened infection control, early identification, and optimized glucose management may improve outcomes in high-risk populations.