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

IF 2.4 4区医学 Q3 MYCOLOGY

Journal de mycologie medicale Pub Date : 2025-12-01 Epub Date: 2025-10-28 DOI:10.1016/j.mycmed.2025.101588

Anis Chaari , Shaikha Ali Asheer , Muqtadir Malik , Mohamad Saif Khan , Manaf Alqahtani

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引用次数: 0

Abstract

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.

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危重患者念珠菌耳念珠菌：流行病学、预测因素及预后影响

目的了解耳念珠菌（Candida auris）念珠菌病在危重症患者中的流行病学特点，确定其预测因素，评价其对预后的影响。方法对两所三级医院的重症监护病房进行回顾性研究。纳入2022年1月1日至2024年3月31日期间入院的所有成年念珠菌病患者。比较两组：耳念珠菌（CA）和非耳念珠菌（NCA）念珠菌血症。结果共纳入51例患者，其中27例（52.9%）为耳念珠菌。耳念珠菌与碳青霉烯耐药肠杆菌的定植率显著相关（51.9 vs 20.8%; p = 0.022）。此外，CA组患者更频繁地暴露于头孢他啶-阿维巴坦（40.7% vs 8.3%; p = 0.008）、替加环素（44.4% vs 12.5%; p = 0.012）和抗真菌药物（74.1% vs 33.3%; p = 0.004）。多因素分析发现，既往接触抗真菌药物是耳念珠菌感染的唯一独立预测因素（OR = 6.5 CI95 % [1.7-25.3]; p = 0.007）。念珠菌病与感染性休克发生率较高相关（83.3% vs 40.7%, p = 0.002），非念珠菌病患者机械通气需求增加（95.8% vs 63%, p = 0.004）。奥瑞丝fungemia。CA组和NCA组28天死亡率为66.7%，差异无统计学意义（OR = 0.3 95% CI [0.1-1.1]; p = 0.08）。结论耳念珠菌已成为icu的优势分离菌。与NCA真菌血症相比，先前暴露于抗真菌药物是主要的预测因素。CA和NCA的28天死亡率相似。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal de mycologie medicale 医学-真菌学

CiteScore

5.10

自引率

2.80%

发文量

审稿时长

6-12 weeks

期刊介绍： The Journal de Mycologie Medicale / Journal of Medical Mycology (JMM) publishes in English works dealing with human and animal mycology. The subjects treated are focused in particular on clinical, diagnostic, epidemiological, immunological, medical, pathological, preventive or therapeutic aspects of mycoses. Also covered are basic aspects linked primarily with morphology (electronic and photonic microscopy), physiology, biochemistry, cellular and molecular biology, immunochemistry, genetics, taxonomy or phylogeny of pathogenic or opportunistic fungi and actinomycetes in humans or animals. Studies of natural products showing inhibitory activity against pathogenic fungi cannot be considered without chemical characterization and identification of the compounds responsible for the inhibitory activity. JMM publishes (guest) editorials, original articles, reviews (and minireviews), case reports, technical notes, letters to the editor and information. Only clinical cases with real originality (new species, new clinical present action, new geographical localization, etc.), and fully documented (identification methods, results, etc.), will be considered. Under no circumstances does the journal guarantee publication before the editorial board makes its final decision. The journal is indexed in the main international databases and is accessible worldwide through the ScienceDirect and ClinicalKey platforms.