Impact of Candida auris on Critically Ill Patients: A Three-Year Observational Study in a Greek Intensive Care Unit

<i>Candida auris</i> has emerged as a multidrug-resistant yeast implicated in healthcare-associated invasive infections and hospital outbreaks. The aim of the current 38-month period observational study in a multidisciplinary Intensive Care Unit (ICU) was to analyze the epidemiology, potential risk factors, management strategies, and patient outcomes of patients with <i>C. auris</i>. During the study period, 32 patients were identified with <i>C. auris</i> infection (6 patients) or colonization (26 patients) and their clinical characteristics and treatment-related factors were compared. Identification of <i>C. auris</i> isolates was confirmed by MALDI-TOF spectrometry. According to our results, regarding patient-related factors, no significant differences were identified. Regarding treatment-related factors, the proportion of patients already receiving corticosteroids (34.6% vs. 83.3%, <i>p</i> = 0.064) or being on renal replacement treatment (7.7% vs. 33.3%) was higher in infected patients. Median time elapsed from ICU admission to first positive culture was 7 (1-21) days and half of cases were ICU-imported. All strains were resistant to fluconazole and susceptible to echinocandines and amphotericin B. Crude mortality of the study population was 43.75%, similar to other previously reported candidemias. Rapid identification of <i>C. auris</i>, continued surveillance, and infection control practices are important elements for controlling successfully its spread in the hospital setting and for establishing promptly its transition from commensalism to infection.