Clinical management, antifungal susceptibility, and predictors of 28-day mortality in Candidozyma auris candidemia: a single-center cohort study

Candidozyma auris (Candida auris) candidemia is a serious healthcare-associated infection with substantial mortality and limited treatment options. We retrospectively evaluated adult patients with C. auris candidemia at a tertiary care center between June 2022 and December 2025 to describe clinical management, microbiological outcomes, antifungal susceptibility, and factors associated with 28-day mortality. The descriptive cohort included 108 patients; mortality status was available for 107. Most patients (92.6%) were in intensive care at candidemia onset, and among evaluable patients, 76.1% had prior C. auris colonisation detected. Twenty-eight-day mortality was 41.1% (44/107). Non-survivors were older and had higher Charlson Comorbidity Index, Pitt bacteremia, and Sequential Organ Failure Assessment (SOFA) scores. Central venous catheter removal was more frequent among survivors (72.7% vs 45.0%; P=.012), although removal timing and time to initiation of effective antifungal therapy did not differ significantly between groups. In multivariable analysis, Charlson Comorbidity Index (adjusted odds ratio [aOR], 1.22; 95% confidence interval [CI], 1.02-1.44) and SOFA score (aOR, 1.16; 95% CI, 1.05-1.27) were independently associated with 28-day mortality. Resistance rates were 95.1% for fluconazole, 31.2% for amphotericin B, and 1.3% for both anidulafungin and micafungin; multidrug resistance rate was 28.6%, and no isolate met the definition of pandrug resistance. Mortality in C. auris candidemia was mainly associated with baseline comorbidity burden and acute organ dysfunction. Local susceptibility surveillance and early recognition of high-risk patients may support treatment and infection-control strategies.