Candida auris in a Romanian Adult Intensive Care Unit: A Retrospective Descriptive Case Series

Candida auris (Candidozyma auris) is an emerging healthcare-associated yeast that requires rapid identification and infection prevention and control (IPC) action in intensive care units (ICUs). We retrospectively described six C. auris-positive adults detected in a Romanian tertiary-hospital ICU between April and June 2025 using routine clinical, microbiological, screening, and IPC records. The outbreak was operationally defined as two or more epidemiologically linked cases with no prior hospital endemicity; active contact screening encompassed all 24 ICU module patients (42 screening encounters using composite axillary/inguinal swabs). Two patients had candidemia (one following screening-detected colonization), and four had colonization without invasive disease. Identification used MALDI-TOF MS; broth microdilution MICs showed fluconazole resistance (>128 mg/L) in both candidemia isolates. IPC measures included isolation, contact precautions, dedicated equipment, enhanced cleaning, and daily 4% chlorhexidine bathing. All six patients died in hospital; deaths are reported as all-cause, as attribution to C. auris was not possible. This single-center cluster expands Romanian experience but highlights the need for prospective denominators and molecular typing.