{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T20:03:48Z","timestamp":1791403428880,"version":"4.3.3"},"reference-count":30,"publisher":"Akademiai Kiado Zrt.","issue":"2","content-domain":{"domain":["akjournals.com"],"crossmark-restriction":true},"short-container-title":["AMicr"],"published-print":{"date-parts":[[2025,6,20]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:italic>Candida auris<\/jats:italic> spreads rapidly and causes outbreaks worldwide. Strict infection control is critical to control its spread; however, it is challenging and requires a special approach. This study aims to investigate the colonization and infection of <jats:italic>C. auris<\/jats:italic> in intensive care units (ICUs), analyses its susceptibility, and mortality rates, and contributes to an effective infection control.<\/jats:p><jats:p>An infection control study was planned, and a <jats:italic>C. auris<\/jats:italic> infection control bundle and checklist were developed. During the study's pre-intervention, intervention, and post-intervention periods, <jats:italic>C. auris<\/jats:italic> candidemia cases and colonized patients were identified. Until the infection control intervention, all the candidemia cases, antifungal resistance, and mortality were investigated retrospectively. Clinical isolates were identified by phenotypic and genotypic characterization using MALDI-TOF MS Biotyper (Bruker Daltonics, Bremen, Germany) and sequencing.<\/jats:p><jats:p>During the pre-intervention, intervention, and post-intervention periods, 26 <jats:italic>C. auris<\/jats:italic> cases were identified. Pan-resistant <jats:italic>C. auris<\/jats:italic> isolates were 3.84%, and the multidrug resistance was 65.38%. With the infection control intervention, the number of colonized patients decreased (pre-intervention 9.61\u2030, intervention 6.19\u2030, post-intervention 5.20\u2030). Candidemia incidence decreased from 4.09 to 2.3\u2030. No new cases of candidemia were observed at the end of the study.<\/jats:p><jats:p>The risk of new cases is elevated in the rooms where multiple <jats:italic>C. auris<\/jats:italic> cases have been previously isolated. Mortality rate was high; namely, 76.92% of patients died, and 19.23% of strains were resistant to anidulofungin, one of the most commonly used antifungals. Despite the short implementation period, the infection control bundle and checklist have been demonstrated to be effective in controlling <jats:italic>C. auris<\/jats:italic> spread in the ICU.<\/jats:p>","DOI":"10.1556\/030.2025.02615","type":"journal-article","created":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T10:53:48Z","timestamp":1749812028000},"page":"164-170","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":3,"title":["Candida auris infections in an intensive care unit: Antifungal resistance, mortality rates and infection control interventions"],"prefix":"10.1556","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1123-3454","authenticated-orcid":true,"given":"Semiha","family":"Solak Grassie","sequence":"first","affiliation":[{"name":"Y\u0131ld\u0131r\u0131m Beyaz\u0131t University Yenimahalle Training and Research Hospital, Infectious Diseases Clinic, Ankara, Turkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nilg\u00fcn","family":"Karab\u0131\u00e7ak","sequence":"additional","affiliation":[{"name":"Public Health Institute of Turkiye, National Mycology Reference Laboratory, Ankara, Turkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tu\u011f\u00e7e","family":"\u00dcnalan Alt\u0131ntop","sequence":"additional","affiliation":[{"name":"Y\u0131ld\u0131r\u0131m Beyaz\u0131t University Yenimahalle Training and Research Hospital, Microbiology Laboratory, Ankara, Turkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"425","reference":[{"key":"B1","series-title":"Curr Fungal Infect Rep","doi-asserted-by":"publisher","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":"Ahmad S","year":"2023","unstructured":"Ahmad S, Asadzadeh M. Strategies to prevent transmission of Candida auris in healthcare settings. Curr Fungal Infect Rep 2023; 17: 36\u201348. 10.1007\/s12281-023-00451-7"},{"issue":"7","key":"B2","series-title":"Am J Infect Control","doi-asserted-by":"publisher","first-page":"825","DOI":"10.1016\/j.ajic.2020.01.021","article-title":"Preparing your healthcare facility for the new fungus among us: an infection preventionist\u2019s guide to Candida auris","volume":"48","author":"Wang TZ","year":"2020","unstructured":"Wang TZ, White KN, Villani J, Simon MS, Calfee DP. Preparing your healthcare facility for the new fungus among us: an infection preventionist\u2019s guide to Candida auris. Am J Infect Control 2020; 48(7): 825\u20137. 10.1016\/j.ajic.2020.01.021"},{"issue":"14","key":"B3","series-title":"Euro Surveill","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917","article-title":"In vivo evolution to echinocandin resistance and increasing clonal heterogeneity in Candida auris during a difficult-to-control hospital outbreak, Italy, 2019 to 2022","volume":"28","author":"Codda G","year":"2023","unstructured":"Codda G, Willison E, Magnasco L, Morici P, Glacobbe DR, Mencacci A, et\u00a0al. In vivo evolution to echinocandin resistance and increasing clonal heterogeneity in Candida auris during a difficult-to-control hospital outbreak, Italy, 2019 to 2022. Euro Surveill 2023; 28(14): 2300161. 10.2807\/1560-7917"},{"issue":"2","key":"B4","series-title":"Microorganism","doi-asserted-by":"publisher","first-page":"181","DOI":"10.3390\/microorganisms8020181","article-title":"Candida Auris, an agent of hospital-associated outbreaks: which challenging issues do we need to have in mind?","volume":"8","author":"Sabino R","year":"2020","unstructured":"Sabino R, Verissimo C, Pereira AA, Antune F. Candida Auris, an agent of hospital-associated outbreaks: which challenging issues do we need to have in mind? Microorganism 2020; 8(2): 181. 10.3390\/microorganisms8020181"},{"issue":"7","key":"B5","series-title":"Antimicrob Agents Chemother","doi-asserted-by":"publisher","DOI":"10.1128\/aac.00053-22","article-title":"Candida auris pan-drug-resistant to four classes of antifungal agents","volume":"66","author":"Jacobs SE","year":"2022","unstructured":"Jacobs SE, Jacobs JL, Dennis EK, Taimur S, Rana M, Pate D, et\u00a0al. Candida auris pan-drug-resistant to four classes of antifungal agents. Antimicrob Agents Chemother 2022; 66(7): e0005322. 10.1128\/aac.00053-22"},{"issue":"4","key":"B6","series-title":"J Fungi","doi-asserted-by":"publisher","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":"Caceres DH","year":"2019","unstructured":"Caceres DH, Forsberg K, Welsh RM, Sexton DJ, Lockhart SR, Jacksan BR, et\u00a0al. Candida auris: a review of recommendations for detection and control in healthcare settings. J Fungi 2019; 5(4): 111. 10.3390\/jof5040111"},{"key":"B7","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"1322","DOI":"10.1056\/NEJMoa1714373","article-title":"A Candida auris outbreak and its control in an intensive care setting","volume":"379","author":"Eyre DW","year":"2018","unstructured":"Eyre DW, Sheppard AE, Madder H, Moir I, Moroney R, Quan TP, et\u00a0al. A Candida auris outbreak and its control in an intensive care setting. N Engl J Med 2018; 379: 1322\u201331. 10.1056\/NEJMoa1714373"},{"issue":"4","key":"B8","series-title":"J Clin Microbiol","doi-asserted-by":"publisher","first-page":"1614","DOI":"10.1128\/JCM.02381-10","article-title":"Performance and cost analysis of matrix-assisted laser desorption ionization-time of flight mass spectrometry for routine identification of yeast","volume":"49","author":"Dhiman N","year":"2011","unstructured":"Dhiman N, Hall L, Wohlfiel SL, Buckwalter SP, Wengenack NL. Performance and cost analysis of matrix-assisted laser desorption ionization-time of flight mass spectrometry for routine identification of yeast. J Clin Microbiol 2011; 49(4): 1614\u20136. 10.1128\/JCM.02381-10"},{"issue":"9","key":"B9","series-title":"J Clin Microbiol","doi-asserted-by":"publisher","first-page":"3139","DOI":"10.1128\/JCM.00319-11","article-title":"First three reported cases of nosocomial fungemia caused by Candida auris","volume":"49","author":"Lee WG","unstructured":"Lee WG, Shin JH, Uh Y, Kang MG, Kim SH, Park KH, et\u00a0al. First three reported cases of nosocomial fungemia caused by Candida auris. J Clin Microbiol; 49(9): 3139\u201342. 2011. 10.1128\/JCM.00319-11"},{"key":"B10","series-title":"Performance standards for antifungal susceptibility testing of yeasts","author":"Clinical and Laboratory Standards Institute","year":"2020","unstructured":"Clinical and Laboratory Standards Institute. Performance standards for antifungal susceptibility testing of yeasts, M60, 2nd Ed. Wayne, PA: Clinical and Laboratory Standards Institute; 2020."},{"key":"B11","series-title":"Reference method for broth dilution antifungal susceptibility testing of yeasts","author":"Clinical and Laboratory Standards Institute","year":"2017","unstructured":"Clinical and Laboratory Standards Institute. Reference method for broth dilution antifungal susceptibility testing of yeasts, 4th ed. Wayne, PA: Clinical and Laboratory Standards Institute; 2017. Approved standard M27."},{"key":"B12","series-title":"Candida auris antifungal susceptibility testing","author":"Centers for Disease Control and Prevention","year":"2024","unstructured":"Centers for Disease Control and Prevention. Candida auris antifungal susceptibility testing; 2024. https:\/\/www.cdc.gov\/fungal\/candida-auris\/c-aurisantifungal.html\/, Accessed 31 July 2024."},{"key":"B13","series-title":"EUCAST","first-page":"1","article-title":"EUCAST definitive document E. Def 7.4: method for the determination of broth dilution minimum inhibitory concentrations of antifungal agents for yeasts","author":"Guinea J","year":"2023","unstructured":"Guinea J, Meletiadis J, Arikan-Akdagli S, Giske C, Muehlethaler K, Arendrup C, et\u00a0al. EUCAST definitive document E. Def 7.4: method for the determination of broth dilution minimum inhibitory concentrations of antifungal agents for yeasts. EUCAST 2023: 1\u201324."},{"key":"B14","series-title":"Mycoses","doi-asserted-by":"publisher","first-page":"753","DOI":"10.1111\/myc.13470","article-title":"Emergence of Candida auris in intensive care units in Algeria","volume":"65","author":"Zerrouki H","year":"2022","unstructured":"Zerrouki H, Ibrahim A, Rebiahi SA, Elhabiri Y, Benhaddouche DE, Groot T, et\u00a0al. Emergence of Candida auris in intensive care units in Algeria. Mycoses 2022; 65: 753\u2013759. 10.1111\/myc.13470"},{"key":"B15","series-title":"BMC Infect Dis","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1186\/s12879-020-05543-0","article-title":"Is the superbug fungus really so scary? A systematic review and meta-analysis of global epidemiology and mortality of Candida auris","volume":"20","author":"Chen J","year":"2020","unstructured":"Chen J, Tian S, Han X, Chu Y, Wang Q, Zohu B, et\u00a0al. Is the superbug fungus really so scary? A systematic review and meta-analysis of global epidemiology and mortality of Candida auris. BMC Infect Dis 2020; 20: 827. 10.1186\/s12879-020-05543-0"},{"issue":"7","key":"B16","series-title":"Emerging Infect Dis","doi-asserted-by":"publisher","first-page":"1485","DOI":"10.3201\/eid2907.230540","article-title":"Candida auris\u2012Associated hospitalizations, United States, 2017\u20132022","volume":"29","author":"Benedict K","year":"2023","unstructured":"Benedict K, Forsberg K, Gold JAW, Baggs J, Lyman M. Candida auris\u2012Associated hospitalizations, United States, 2017\u20132022. Emerging Infect Dis 2023; 29(7): 1485\u20137. 10.3201\/eid2907.230540"},{"key":"B17","series-title":"Curr Opin Microbiol","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1016\/j.mib.2019.05.008","article-title":"Global epidemiology of emerging Candida auris","volume":"52","author":"Rhodes J","year":"2019","unstructured":"Rhodes J, Fisher MC. Global epidemiology of emerging Candida auris. Curr Opin Microbiol 2019; 52: 84\u20139. 10.1016\/j.mib.2019.05.008"},{"issue":"4","key":"B18","series-title":"Ann Intern Med","doi-asserted-by":"publisher","first-page":"489","DOI":"10.7326\/M22-3469","article-title":"Worsening spread of Candida auris in the United States, 2019 to 2021","volume":"176","author":"Lyman M","year":"2023","unstructured":"Lyman M, Forsberg K, Sexton DJ, Chow NA, Lockhart SR, Jackson BR, et\u00a0al. Worsening spread of Candida auris in the United States, 2019 to 2021. Ann Intern Med 2023; 176(4): 489\u201395. 10.7326\/M22-3469"},{"issue":"9","key":"B19","series-title":"J Fungi","doi-asserted-by":"publisher","first-page":"913","DOI":"10.3390\/jof9090913","article-title":"An overview on Candida auris in healthcare settings","volume":"9","author":"Cristina ML","year":"2023","unstructured":"Cristina ML, Spagnolo AM, Carbone A, Oliva M, Schinca E, et\u00a0al. An overview on Candida auris in healthcare settings. J Fungi 2023; 9(9): 913. 10.3390\/jof9090913"},{"issue":"4","key":"B20","series-title":"New Microbiologica","first-page":"395","article-title":"Successful control measures to treat the transmission of Candida auris in Northern Italian Hospital","volume":"46","author":"Giovagnorio F","year":"2023","unstructured":"Giovagnorio F, Geremia N, Scarparo C, Panese S, Bradariolo S, Berti C, et\u00a0al. Successful control measures to treat the transmission of Candida auris in Northern Italian Hospital. New Microbiologica 2023; 46(4): 395\u20139."},{"issue":"6","key":"B21","series-title":"Infect Control & Hosp Epidemiol","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1017\/ice.2023.251","article-title":"Persistent colonization of Candida auris among inpatients rescreened as part of a weekly surveillance program","volume":"45","author":"Arenas SP","year":"2024","unstructured":"Arenas SP, Persad PJ, Patel S, Parekh DJ, Ferreira TBD, Farinas M, et\u00a0al. Persistent colonization of Candida auris among inpatients rescreened as part of a weekly surveillance program. Infect Control & Hosp Epidemiol 2024; 45(6): 762\u2013765. 10.1017\/ice.2023.251"},{"issue":"7","key":"B22","series-title":"Emerging Infect Dis","doi-asserted-by":"publisher","first-page":"1302","DOI":"10.3201\/eid2907.221888","article-title":"Nationwide outbreak of Candida auris infections driven by COVID-19 hospitalizations, Israel, 2021\u20132022","volume":"29","author":"Biran R","year":"2023","unstructured":"Biran R, Cohen R, Finn T, Brosh-Nissimov T, Rahav G, Yahav D, et\u00a0al. Nationwide outbreak of Candida auris infections driven by COVID-19 hospitalizations, Israel, 2021\u20132022. Emerging Infect Dis 2023; 29(7): 1302\u201311. 10.3201\/eid2907.221888"},{"issue":"9","key":"B23","series-title":"Antibiotics","doi-asserted-by":"publisher","first-page":"558","DOI":"10.3390\/antibiotics9090558","article-title":"Characteristics and management of candidaemia episodes in an established Candida auris outbreak","volume":"9","author":"Bayona JVM","year":"2020","unstructured":"Bayona JVM, Palop NT, Garcia CS, Rodriguez PH, Medrano VAL, Gomez CF, et\u00a0al. Characteristics and management of candidaemia episodes in an established Candida auris outbreak. Antibiotics 2020; 9(9): 558. 10.3390\/antibiotics9090558"},{"key":"B24","series-title":"Curr Fungal Infect Rep","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1007\/s12281-021-00420-y","article-title":"Candida auris: diagnostic challenges and emerging opportunities for the clinical microbiology laboratory","volume":"15","author":"Keihley C","year":"2021","unstructured":"Keihley C, Garnham K, Harch SAj, Robertson M, Chaw K, Teng JC, et\u00a0al. Candida auris: diagnostic challenges and emerging opportunities for the clinical microbiology laboratory. Curr Fungal Infect Rep 2021; 15: 116\u201326. 10.1007\/s12281-021-00420-y"},{"key":"B25","series-title":"Antimicrob Resist Infect Control","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1186\/s13756-016-0132-5","article-title":"First hospital outbreak of the globally emerging Candida auris in a European hospital","volume":"5","author":"Schelenz S","year":"2016","unstructured":"Schelenz S, Hagen F, Rhodes JL, Abdolrasoulin A, Chowhardy A, Hall A, et\u00a0al. First hospital outbreak of the globally emerging Candida auris in a European hospital. Antimicrob Resist Infect Control 2016; 5: 35. 10.1186\/s13756-016-0132-5"},{"key":"B26","series-title":"Front Microbiol","doi-asserted-by":"publisher","first-page":"726","DOI":"10.3389\/fmicb.2018.00726","article-title":"Candida auris: disinfectants and implications for infection control","volume":"9","author":"Ku TSN","year":"2018","unstructured":"Ku TSN, Walraven CJ, Lee SA. Candida auris: disinfectants and implications for infection control. Front Microbiol 2018; 9: 726. 10.3389\/fmicb.2018.00726"},{"issue":"3","key":"B27","series-title":"J Hosp Infect","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1016\/j.jhin.2012.04.011","article-title":"Improving implementation of infection control guidelines to reduce nosocomial infection rates: pioneering the report card","volume":"81","author":"Yinnon AM","year":"2012","unstructured":"Yinnon AM, Wiener\u2013Well Y, Jerassy Z, Dor M, Freund R, Mazouz B, et\u00a0al. Improving implementation of infection control guidelines to reduce nosocomial infection rates: pioneering the report card. J Hosp Infect 2012; 81(3): 169\u201376. 10.1016\/j.jhin.2012.04.011"},{"key":"B28","article-title":"Candida auris isolates resistant to three classes of antifungal medications-New York, 2019","author":"Ostrowsky B","unstructured":"Ostrowsky B, Greenko J, Adams E, Quinn M, O\u2019Brien B, Chaturvedi V, et\u00a0al. Candida auris isolates resistant to three classes of antifungal medications-New York, 2019. A CDC report. available from https:\/\/www.cdc.gov\/mmwr\/volumes\/69\/wr\/mm6901a2.htm."},{"issue":"4","key":"B29","series-title":"Microbiol Open","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/mbo3.578","article-title":"Candida auris: a systematic review and meta-analysis of current updates on an emerging multidrug-resistant pathogen","volume":"7","author":"Sekyere JO","year":"2018","unstructured":"Sekyere JO. Candida auris: a systematic review and meta-analysis of current updates on an emerging multidrug-resistant pathogen. Microbiol Open 2018; 7(4): 1\u201329. 10.1002\/mbo3.578"},{"key":"B30","series-title":"J Antimicrob Chemother","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1093\/jac\/dkx480","article-title":"A multicenter study of antifungal susceptibility patterns among 350 Candida auris isolates (2009\u201317) in India: role of the ERG11 and FKS1 genes in azole and echinocandin resistance","volume":"73","author":"Chowdhary A","year":"2018","unstructured":"Chowdhary A, Prakash A, Sharma C, Kordalewska M, Kumar A, Sharma S, et\u00a0al. A multicenter study of antifungal susceptibility patterns among 350 Candida auris isolates (2009\u201317) in India: role of the ERG11 and FKS1 genes in azole and echinocandin resistance. J Antimicrob Chemother 2018; 73: 891\u20139. 10.1093\/jac\/dkx480"}],"container-title":["Acta Microbiologica et Immunologica Hungarica"],"original-title":[],"link":[{"URL":"https:\/\/akjournals.com\/view\/journals\/030\/72\/2\/article-p164.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/akjournals.com\/downloadpdf\/journals\/030\/72\/2\/article-p164.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/akjournals.com\/downloadpdf\/journals\/030\/72\/2\/article-p164.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T14:21:37Z","timestamp":1750429297000},"score":1,"resource":{"primary":{"URL":"https:\/\/akjournals.com\/view\/journals\/030\/72\/2\/article-p164.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,20]]},"references-count":30,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.1556\/030.2025.02615","relation":{},"ISSN":["1217-8950","1588-2640"],"issn-type":[{"value":"1217-8950","type":"print"},{"value":"1588-2640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,20]]}}}