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Introduction <p><i>Candida auris</i> has emerged as a significant global health threat due to its resistance to multiple antifungal agents and its prominent role in healthcare-associated infections. This study aims to compare the clinical characteristics, risk factors, antifungal resistance profiles, and mortality rates of candidemia caused by <i>C. auris</i> and non-auris <i>Candida</i> spp. (NACS).</p> Materials and methods <p>This retrospective cohort study was conducted at a tertiary care hospital from 2021 to 2024. Patients aged 18 years and older with positive blood cultures for <i>Candida</i> spp. were included. Demographic data, comorbidities, risk factors, mortality rates, and treatment protocols were analyzed.</p> Results <p>A total of 1,088 candidemia cases were included in the study (<i>C. auris</i>: 126 cases, NACS: 962 cases). The length of hospital stay was significantly longer in the <i>C. auris</i> group compared to the NACS group (50.98 ± 38.79 vs. 33.05 ± 25.57 days, <i>p</i> &lt; 0.001). Independent risk factors for <i>C. auris</i> candidemia included longer hospitalization before candidemia (OR 1.01, 95% CI 1.01–1.02, <i>p</i> &lt; 0.001), chronic obstructive pulmonary disease (OR 1.89, 95% CI 1.07–3.31, <i>p</i> = 0.026), prior antifungal use within 30 days (OR 1.92, 95% CI 1.22–3.03, <i>p</i> = 0.005), and ICU admission (OR 2.08, 95% CI 1.10–3.92, <i>p</i> = 0.023). Antifungal resistance rates among <i>C. auris</i> isolates were 96.49% for fluconazole, 72.81% for amphotericin B, and 25.89% for caspofungin. The 30-day mortality rate was lower in the <i>C. auris</i> group (48.4%) compared to the NACS group (60.2%) (<i>p</i> = 0.012).</p> Conclusion <p>Although crude 30-day mortality was lower in the <i>C. auris</i> group, adjusted analysis showed comparable 30-day mortality between the <i>C. auris</i> and NACS groups. These findings highlight the increasing clinical burden of C. <i>auris</i> and support accurate species identification, local antifungal susceptibility surveillance, and rigorous infection-control measures.</p> Clinical trial number <p>Not applicable.</p>

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Comparison of candidemia caused by Candida auris and non-auris Candida spp.: a retrospective cohort study on clinical characteristics, risk factors, and antifungal resistance profiles

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月25日

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  • Ramazan Korkusuz,
  • Selda Kömeç,
  • Esin Çevik,
  • Alev Öztaş,
  • Özlem Altuntaş Aydın,
  • Onur Özalp,
  • Gülçin Hilal Alay

摘要

Introduction

Candida auris has emerged as a significant global health threat due to its resistance to multiple antifungal agents and its prominent role in healthcare-associated infections. This study aims to compare the clinical characteristics, risk factors, antifungal resistance profiles, and mortality rates of candidemia caused by C. auris and non-auris Candida spp. (NACS).

Materials and methods

This retrospective cohort study was conducted at a tertiary care hospital from 2021 to 2024. Patients aged 18 years and older with positive blood cultures for Candida spp. were included. Demographic data, comorbidities, risk factors, mortality rates, and treatment protocols were analyzed.

Results

A total of 1,088 candidemia cases were included in the study (C. auris: 126 cases, NACS: 962 cases). The length of hospital stay was significantly longer in the C. auris group compared to the NACS group (50.98 ± 38.79 vs. 33.05 ± 25.57 days, p < 0.001). Independent risk factors for C. auris candidemia included longer hospitalization before candidemia (OR 1.01, 95% CI 1.01–1.02, p < 0.001), chronic obstructive pulmonary disease (OR 1.89, 95% CI 1.07–3.31, p = 0.026), prior antifungal use within 30 days (OR 1.92, 95% CI 1.22–3.03, p = 0.005), and ICU admission (OR 2.08, 95% CI 1.10–3.92, p = 0.023). Antifungal resistance rates among C. auris isolates were 96.49% for fluconazole, 72.81% for amphotericin B, and 25.89% for caspofungin. The 30-day mortality rate was lower in the C. auris group (48.4%) compared to the NACS group (60.2%) (p = 0.012).

Conclusion

Although crude 30-day mortality was lower in the C. auris group, adjusted analysis showed comparable 30-day mortality between the C. auris and NACS groups. These findings highlight the increasing clinical burden of C. auris and support accurate species identification, local antifungal susceptibility surveillance, and rigorous infection-control measures.

Clinical trial number

Not applicable.