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The Ramifications of Candida auris Colonization and Infection in Intensive Care Units: Epidemiology, Risk Factors,
E Hashish1, A Omar2, M Alwaseef2
1Department of Hospital Administration, High Institute of Public Health, Alexandria, Egypt.
Background:
Candida auris (C. auris) has emerged as one of the most formidable healthcare-associated fungal pathogens, particularly within intensive care units (ICUs) where prolonged antimicrobial exposure, invasive procedures, and critical illness converge. its persistence in hospital environments and resistance pattern to several antifungal classes make it a serious infection-control concern globally and a growing threat to patient safety in high-acuity hospital settings.
Objectives:
This study investigated the epidemiological, clinical, and microbiological profiles of intensive care unit (ICU) patients with laboratory-confirmed C. auris infection and assessed its association with carbapenem-resistant Enterobacterales (CRE) co-infection and relevant clinical risk factors.
Methods:
A cross-sectional observational study was conducted among forty intensive care unit (ICU) patients admitted to Al-Azhar University Hospitals and affiliated private facilities between January and August 2025. All C. auris isolates were identified using CHROMagar culture and molecularly confirmed by real-time PCR. Data were analyzed using SPSS version 25 and Python for reproducibility. Descriptive and inferential statistics were applied, with categorical variables evaluated by Chi-square test and statistical significance defined at p < 0.05.
Results:
The mean age of the forty ICU patients was 67.0 ± 15.2 years, with an equal male-to-female ratio (1:1). C. auris infection demonstrated significant associations with bacterial pneumonia, cerebral haemorrhage, and septic shock (χ² = 6.24, p = 0.013). Co-isolation of carbapenem-resistant Klebsiella species (CRE) was detected in 65 % of cases (χ² = 5.61, p = 0.021). Age and sex were not significant predictors of infection risk (p > 0.05).
Conclusion:
C. auris infection in intensive care units (ICUs) predominantly affects elderly, critically ill patients and frequently coexists with carbapenem-resistant Klebsiella species (CRE). Its persistence and multidrug resistance necessitate routine PCR-based screening, integrated fungal-bacterial surveillance, and strict adherence to contact-precaution protocols. In addition, chlorine-based environmental disinfection and evidence-driven containment strategies are essential to prevent cross-transmission and to maintain infection-control resilience in high-risk healthcare environments.
Insights
Candida auris (C. auris) infections in ICUs primarily affect elderly, critically ill patients and often co-occur with carbapenem-resistant Enterobacterales (CRE). Effective control requires integrated surveillance, PCR screening, and strict infection-prevention protocols.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Critical Care Medicine
Background:
- Candida auris (C. auris) is a significant healthcare-associated fungal pathogen, posing a global infection control challenge.
- Its persistence in hospital environments and antifungal resistance make it a growing threat in high-acuity settings, especially intensive care units (ICUs).
Purpose of the Study:
- To investigate the epidemiological, clinical, and microbiological profiles of ICU patients with C. auris infection.
- To assess the association of C. auris with carbapenem-resistant Enterobacterales (CRE) co-infection and clinical risk factors.
Main Methods:
- A cross-sectional observational study of 40 ICU patients with laboratory-confirmed C. auris infection.
- Isolates identified using CHROMagar and confirmed by real-time PCR; data analyzed using SPSS and Python.
- Descriptive and inferential statistics, including Chi-square tests, were applied (p < 0.05).
Main Results:
- C. auris infection was associated with bacterial pneumonia, cerebral hemorrhage, and septic shock (p = 0.013).
- Carbapenem-resistant Klebsiella species (CRE) co-infection occurred in 65% of cases (p = 0.021).
- Age and sex were not significant predictors of infection risk.
Conclusions:
- C. auris infection in ICUs predominantly affects elderly, critically ill patients and frequently coexists with CRE.
- Routine PCR screening, integrated fungal-bacterial surveillance, and strict contact precautions are essential.
- Chlorine-based disinfection and containment strategies are vital for preventing transmission in high-risk environments.
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