{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T21:49:57Z","timestamp":1793137797566,"version":"4.5.0"},"reference-count":29,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T00:00:00Z","timestamp":1735862400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"\n Background<\/jats:title>\n \n Candida auris<\/jats:italic>\n (C. auris) is an emerging fungus pathogen associated with nosocomial infections that is seen as a serious global health issue.\n <\/jats:p>\n <\/jats:sec>\n \n Aim<\/jats:title>\n \n To describe the epidemiology and features of hospital-acquired\n Candida auris<\/jats:italic>\n outbreaks in the Ministry of Health hospitals (MOH).\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A three-year (2020\u20132022) retrospective analysis of\n Candida auris<\/jats:italic>\n outbreaks in the Saudi MOH hospitals. A total of 45 hospitals were involved, with 511 cases of\n Candida auris<\/jats:italic>\n . The data collected from the General Directorate of Infection Prevention and Control (GDIPC) platform comprises all patients\u2019 data for\n C<\/jats:italic>\n .\n auris<\/jats:italic>\n instances, whether infected or colonized.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Out of the 511 Candida auris recruited cases, 291 (56.9%) were infected, whereas 220 (43.1%) were colonized. 32.9% of cases were above the age of 65, and 68.9% were male. The majority of cases were admitted in the ICU unit (95.5%). Approximately 18.8% of cases were diabetes, and 18.5% were hypertensive. Central lines were discovered in 37.7% of the cases. Approximately 85.9% of cases had Foley catheters, 68.5% were on ventilators, and 53.8% had a tracheostomy. The crude mortality rate was particularly high (41.5%) among the study cases. It was non-significantly higher among infected individuals (44.7%) than colonized patients (37.3%) at (\n p value<\/jats:italic>\n = 0.093). The prevalence of hypertension (p = 0.001), DM (p = 0.003), and peripheral line insertion (p = 0.004) was significantly higher among colonized patients. While the presence of COVID-19 (p = 0.001), and central line insertion (p = 0.001) was significantly higher among infected patients.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n C<\/jats:italic>\n .\n auris<\/jats:italic>\n is a new pathogen that causes hospital outbreaks. Strict adherence to infection prevention and control criteria established by the Centre for Disease Control (CDC) and GDPIC has significantly contained and reduced the spread of these outbreaks. One-month retrospective surveillance before diagnosing the index case and a prospective surveillance strategy for at least three months is highly recommended.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0313589","type":"journal-article","created":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T13:49:21Z","timestamp":1735912161000},"page":"e0313589","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":23,"title":["An overview of healthcare-associated Candida auris outbreaks in Ministry of Health hospitals\u2013Saudi Arabia 2020\u20132022; Retrospective multicentric study"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1016-3714","authenticated-orcid":true,"given":"Khalid H.","family":"Alanazi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8595-3102","authenticated-orcid":true,"given":"Hala M.","family":"Roushdy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1597-8393","authenticated-orcid":true,"given":"Waad I.","family":"ALzubaidi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0393-4022","authenticated-orcid":true,"given":"Arwa S.","family":"Alanazi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nawal M.","family":"Alanazi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahlam H.","family":"Alamri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yahya I.","family":"Alnshbah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nawaf M.","family":"AL Almatrafi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2113-8400","authenticated-orcid":true,"given":"Zainah M.","family":"Al Shahrani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adel S.","family":"Alanazi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasser H.","family":"Alshanbari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,1,3]]},"reference":[{"issue":"1","key":"pone.0313589.ref001","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/mmy\/myy054","article-title":"Candida auris: The recent emergence of a multidrug-resistant fungal pathogen","volume":"57","author":"K Forsberg","year":"2019","journal-title":"Medical mycology"},{"issue":"3","key":"pone.0313589.ref002","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1080\/21501203.2023.2227218","article-title":"Risk factors and mortality of the newly emerging Candida auris in a university hospital in Saudi Arabia","volume":"14","author":"R. Kaki","year":"2023","journal-title":"Mycology"},{"issue":"4","key":"pone.0313589.ref003","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1038\/s41579-023-00861-x","article-title":"The WHO fungal priority pathogens list as a game-changer","volume":"21","author":"MC Fisher","year":"2023","journal-title":"Nature Reviews Microbiology"},{"issue":"5","key":"pone.0313589.ref004","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/j.jinf.2019.02.004","article-title":"Neurosurgical device-associated infections due to Candida auris\u2013Three cases from a single tertiary center","volume":"78","author":"E Khatamzas","year":"2019","journal-title":"Journal of Infection"},{"issue":"4","key":"pone.0313589.ref005","doi-asserted-by":"crossref","DOI":"10.3390\/microorganisms9040807","article-title":"Candida auris: Epidemiology, Diagnosis, Pathogenesis, Antifungal Susceptibility, and Infection Control Measures to Combat the Spread of Infections in Healthcare Facilities","volume":"9","author":"S Ahmad","year":"2021","journal-title":"Microorganisms"},{"key":"pone.0313589.ref006","first-page":"374","article-title":"Candida auris: CDC warns of risk of new, drug-resistant strain in US","author":"JH Tanne","year":"2021","journal-title":"BMJ (Clinical research ed)"},{"issue":"2","key":"pone.0313589.ref007","doi-asserted-by":"crossref","first-page":"81","DOI":"10.3390\/jof7020081","article-title":"Colonisation and transmission dynamics of Candida auris among chronic respiratory diseases patients hospitalised in a chest hospital, Delhi, India: a comparative analysis of whole genome sequencing and microsatellite typing","volume":"7","author":"A Yadav","year":"2021","journal-title":"Journal of Fungi"},{"issue":"5","key":"pone.0313589.ref008","volume":"13","author":"SC Howdhary A","year":"2017","journal-title":"Candida auris: A rapidly emerging cause of hospital-acquired multidrug-resistant fungal infections globally"},{"key":"pone.0313589.ref009","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1007\/s10096-013-2027-1","article-title":"Multidrug-resistant endemic clonal strain of Candida auris in India","volume":"33","author":"A Chowdhary","year":"2014","journal-title":"European journal of clinical microbiology & infectious diseases"},{"key":"pone.0313589.ref010","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.jhin.2021.11.004","article-title":"Colonization by Candida auris in critically ill patients: role of cutaneous and rectal localization during an outbreak","volume":"120","author":"G Piatti","year":"2022","journal-title":"Journal of Hospital Infection"},{"issue":"2","key":"pone.0313589.ref011","doi-asserted-by":"crossref","first-page":"260","DOI":"10.20411\/pai.v4i2.291","article-title":"Environmental Contamination with Candida Species in Multiple Hospitals Including a Tertiary Care Hospital with a Candida auris Outbreak","volume":"4","author":"J Kumar","year":"2019","journal-title":"Pathog Immun"},{"issue":"6","key":"pone.0313589.ref012","doi-asserted-by":"crossref","first-page":"1794","DOI":"10.1093\/jac\/dkx034","article-title":"Candida auris candidaemia in Indian ICUs: analysis of risk factors","volume":"72","author":"SM Rudramurthy","year":"2017","journal-title":"Journal of Antimicrobial Chemotherapy"},{"issue":"4","key":"pone.0313589.ref013","volume":"2017","author":"DPK Frederic Lamoth","year":"2018","journal-title":"The Candida auris Alert: Facts and Perspectives"},{"key":"pone.0313589.ref014","doi-asserted-by":"crossref","first-page":"e01007","DOI":"10.1016\/j.idcr.2020.e01007","article-title":"Experience of treating Candida auris cases at a general hospital in the state of Qatar","volume":"23","author":"A Shaukat","year":"2021","journal-title":"IDCases"},{"issue":"1","key":"pone.0313589.ref015","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1007\/s12281-023-00451-7","article-title":"Strategies to Prevent Transmission of Candida auris in Healthcare Settings","volume":"17","author":"S Ahmad","year":"2023","journal-title":"Curr Fungal Infect Rep"},{"key":"pone.0313589.ref016","unstructured":"US Centers for Disease Control and Prevention. Candida Auris 2019 case definition. Available from https:\/\/ndc.services.cdc.gov\/case-definitions\/candida-auris-2019. Accessed 21 October 2024."},{"key":"pone.0313589.ref017","unstructured":"Saudi MOH. Healthcare-Associated Outbreak Management Manual. September 2023. V.7.1. Available from: https:\/\/www.moh.gov.sa\/Ministry\/Rules\/Documents\/Healthcare-Associated-Outbreak-Management-Manual.pdf. Accessed 21 October 2024."},{"key":"pone.0313589.ref018","unstructured":"Saudi General Directorate for Infection Prevention and Control. Guidance for Candida Auris Infection Prevention and Control measures. Version 2. 2023. Available from: https:\/\/jed-s3.bluvalt.com\/psj1-ifn-s3-ifn01\/files\/12\/Guidelines\/Candida%20Auris%20Infection%20Prevention%20&%20Control%20Guidelines.pdf. Accessed 22 October 2024."},{"key":"pone.0313589.ref019","unstructured":"US Centers for Disease Control and Prevention. Antifungal susceptibility testing and interpretation, Available from https:\/\/www.cdc.gov\/candida-auris\/hcp\/laboratories\/antifungalsusceptibilitytesting.html?CDC_AAref_Val=https:\/\/www.cdc.gov\/fungal\/candida-auris\/c-auris-antifungal.html. Accessed 21 October 2024."},{"issue":"4","key":"pone.0313589.ref020","doi-asserted-by":"crossref","first-page":"111","DOI":"10.3390\/jof5040111","article-title":"Candida auris: A Review of Recommendations for Detection and Control in Healthcare Settings","volume":"5","author":"DH Caceres","year":"2019","journal-title":"J Fungi (Basel)"},{"issue":"4","key":"pone.0313589.ref021","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1007\/s44197-023-00154-9","article-title":"Characteristics and Mitigation Measures of Candida auris Infection: Descriptive Analysis from a Quaternary Care Hospital in Saudi Arabia, 2021\u20132022","volume":"13","author":"HA Amer","year":"2023","journal-title":"Journal of Epidemiology and Global Health"},{"issue":"11","key":"pone.0313589.ref022","doi-asserted-by":"crossref","first-page":"2694","DOI":"10.3201\/eid2611.203504","article-title":"Multidrug-resistant Candida auris infections in critically ill coronavirus disease patients, India, April\u2013July 2020","volume":"26","author":"A Chowdhary","year":"2020","journal-title":"Emerging infectious diseases"},{"key":"pone.0313589.ref023","volume-title":"InOpen Forum Infectious Diseases 2023 Mar 1 (Vol. 10, No. 3, p. ofad123)","author":"P McGann"},{"key":"pone.0313589.ref024","volume-title":"StatPearls","author":"A Sikora","year":"2023"},{"issue":"4","key":"pone.0313589.ref025","doi-asserted-by":"crossref","first-page":"307","DOI":"10.3390\/jof6040307","article-title":"Molecular epidemiology of Candida auris outbreak in a major secondary-care hospital in Kuwait","volume":"6","author":"W Alfouzan","year":"2020","journal-title":"Journal of Fungi"},{"issue":"10","key":"pone.0313589.ref026","doi-asserted-by":"crossref","first-page":"1670","DOI":"10.3201\/eid1910.130393","article-title":"New clonal strain of Candida auris, Delhi, India: new clonal strain of Candida auris, Delhi, India","volume":"19","author":"A Chowdhary","year":"2013","journal-title":"Emerging infectious diseases"},{"key":"pone.0313589.ref027","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/j.ijid.2014.03.1018","article-title":"Factors associated with mortality among patients with candidaemia in South Africa, 2012","volume":"21","author":"MC Fortuin-de Smidt","year":"2014","journal-title":"International Journal of Infectious Diseases"},{"key":"pone.0313589.ref028","first-page":"2020","article-title":"Emergence of clade III Candida auris of African origin in Los Angeles","volume":"27","author":"TK Price","year":"2020","journal-title":"medRxiv"},{"key":"pone.0313589.ref029","article-title":"Candida auris outbreak in a COVID-19 specialty care unit\u2014Florida, July\u2013August 2020. 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