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Key Factors to Consider for Candida auris Screening in Healthcare Settings: A Systematic Review
Anders Skyrud Danielsen1, Liz Ertzeid Ødeskaug1, Ragnhild Raastad1
1Department of Infection Control and Preparedness, Norwegian Institute of Public Health, Oslo, Norway.
Mycoses
|March 12, 2025
Summary
Candida auris colonization can last over a year, primarily on skin in the groin and armpits. Risk factors include critical care and invasive devices, but evidence for screening guidelines remains limited.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Public Health
Background:
- Candida auris is a multidrug-resistant fungal pathogen causing outbreaks.
- It colonizes skin and hospital environments, posing risks to vulnerable patients.
- Current prevention guidelines are under development globally.
Purpose of the Study:
- To review evidence on factors associated with Candida auris colonization or infection.
- To determine the duration and common sites of Candida auris colonization.
- To assess the risk of secondary Candida auris cases to inform screening.
Main Methods:
- Systematic search of five databases for primary studies and reviews.
- Exclusion of studies on treatment, management, lab methods, drug resistance, and environmental screening.
- Narrative summary of extracted data from 117 included studies.
Main Results:
- Colonization duration can exceed one year, with axillae and groin as predominant sites.
- Risk of secondary cases varied, mainly affecting patients.
- Critical care, invasive devices, antimicrobial use, and comorbidities are associated with colonization/infection.
Conclusions:
- Evidence gaps exist for Candida auris screening practices.
- Most studies were reactive, conducted during outbreaks, and lacked systematic protocols.
- Future screening guidelines need to integrate medical theory and yeast microbiology; rigorous research is essential.
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