{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T04:16:51Z","timestamp":1770524211586,"version":"3.49.0"},"reference-count":53,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T00:00:00Z","timestamp":1730419200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p><jats:italic>Candida auris<\/jats:italic> is an emerging pathogen that represents a worldwide health problem due to its global expansion, multidrug resistance, and difficult laboratory identification. Among the risk factors for colonization\/infection by <jats:italic>C. auris<\/jats:italic>, a stay in an intensive care unit (ICU) stands out. This prospective multicenter study aimed to monitor the trend of the local epidemiology of <jats:italic>Candida<\/jats:italic> spp. and unveil the prevalence of <jats:italic>C. auris<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From 2020 to 2022, axillar\/inguinal swabs were collected from adult patients at three points: upon admission (D1) and on the fifth (D5) and eighth (D8) days of their ICU stay. We employed culture-based screening methods combined with molecular techniques to identify <jats:italic>Candida<\/jats:italic> spp. down to the species level. Specific screening for <jats:italic>Candida auris<\/jats:italic> was conducted using a real-time PCR assay in combination with an improved selective culture medium, mannitol salt agar auris (MSAA). To validate the effectiveness of MSAA, a collection of reference <jats:italic>C. auris<\/jats:italic> strains representing the four major geographical clades was used.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We enrolled 675 patients, and 355 <jats:italic>Candida<\/jats:italic> isolates were retrieved from the 988 swab samples collected. From those, 185\/355 (52.1%) were identified as <jats:italic>C. albicans<\/jats:italic> and 170\/355 (47.9%) as non-<jats:italic>albicans Candida<\/jats:italic> (NAC). MSAA medium showed a specificity of 94.8%, albeit <jats:italic>C. auris<\/jats:italic> was not detected in this cohort. The dynamics of <jats:italic>Candida<\/jats:italic> spp. colonization by ICU were significant at the three collection points. Upon admission, <jats:italic>C. albicans<\/jats:italic> was associated with the Beatriz \u00c2ngelo Hospital ICU (<jats:italic>p<\/jats:italic>=0.003) and <jats:italic>C. tropicalis<\/jats:italic> with the general Hospital Professor Doutor Fernando Fonseca (FFH) ICU (<jats:italic>p<\/jats:italic>=0.006). <jats:italic>C. parapsilosis<\/jats:italic> and <jats:italic>C. lusitaniae<\/jats:italic> were associated with FFH ICUs, with the general ICU at D5 (<jats:italic>p<\/jats:italic>=0.047) and surgical ICU at D8 (<jats:italic>p<\/jats:italic>=0.012). The dynamics of NAC colonization by ICU were significantly different at D1 (<jats:italic>p<\/jats:italic>=0.011), D5 (<jats:italic>p<\/jats:italic>=0.047), and D8 (<jats:italic>p<\/jats:italic>=0.012).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We developed and implemented a screening protocol for <jats:italic>C. auris<\/jats:italic> while uncovering the colonization patterns of <jats:italic>Candida<\/jats:italic> in the ICU. Our findings contribute to the optimization of overall patient management, ensuring that ICU protocols are resilient and adaptive to emerging fungal threats.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcimb.2024.1463456","type":"journal-article","created":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T06:10:58Z","timestamp":1730441458000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Enhancing ICU Candida spp. surveillance: a cost-effective approach focused on Candida auris detection"],"prefix":"10.3389","volume":"14","author":[{"given":"Teresa","family":"Nascimento","sequence":"first","affiliation":[]},{"given":"Jo\u00e3o","family":"In\u00e1cio","sequence":"additional","affiliation":[]},{"given":"Daniela","family":"Guerreiro","sequence":"additional","affiliation":[]},{"given":"Priscila","family":"Diaz","sequence":"additional","affiliation":[]},{"given":"Patr\u00edcia","family":"Patr\u00edcio","sequence":"additional","affiliation":[]},{"given":"Lu\u00eds","family":"Proen\u00e7a","sequence":"additional","affiliation":[]},{"given":"Cristina","family":"Toscano","sequence":"additional","affiliation":[]},{"given":"Helena","family":"Barroso","sequence":"additional","affiliation":[]}],"member":"1965","published-online":{"date-parts":[[2024,11,1]]},"reference":[{"key":"B1","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","year":"2023","journal-title":"Curr. 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