Candidozyma auris in intensive care units: A point prevalence study and six-month colonization–infection surveillance

BACKGROUND: Candidozyma auris has emerged as a globally significant nosocomial pathogen due to its multidrug antifungal resistance, environmental persistence, and high mortality rates. This study aimed to determine the prevalence of C. auris colonization through a point prevalence screening in the intensive care units (ICUs) of our hospital and to evaluate colonization and infection outcomes during a subsequent six-month follow-up period. OBJECTIVES: The present study aimed to evaluate C. auris colonization rates through point prevalence screening in the ICUs of our hospital, to assess colonization and infection outcomes during a subsequent six-month follow-up period, and to establish a diagnostic algorithm for C. auris identification in our laboratory. METHODS: Following the detection of an index C. auris case in our hospital in February 2025, a point prevalence study was conducted in all ICUs. Composite swab samples (bilateral axilla and groin) were obtained from hospitalized patients on the same day. In addition, urine and wound cultures were collected from eligible patients. Isolates were identified using chromogenic media, conventional microbiological methods, and MALDI-TOF MS. After the point prevalence study, surveillance for colonization and bloodstream infection was performed over a six-month period. RESULTS: C. auris colonization was detected in 7 of 70 ICU patients (10%) based on composite swab samples. During the six-month follow-up, colonization was identified in 15 patients, and C. auris fungemia developed in nine patients. All patients with positive blood cultures died. The most frequently identified risk factors were broad-spectrum antibiotic use, prolonged ICU stay, and the presence of urinary catheters. CONCLUSION: Our findings demonstrate that C. auris colonization can be detected at a high rate in ICUs and that severe invasive infections may develop following colonization. Early diagnosis, active screening strategies, and effective infection control measures are critical for reducing C. auris-associated morbidity and mortality.