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Volume 32, Number 11—November 2026
Synopsis
Predictors and Patterns of Metastatic Candidozyma auris Infection, Spain, 2016–2024
Pedro Suarez-Urquiza1, Alba Ruiz-Gaitán1
, Eva Calabuig, María Tasias, Víctor García Bustos, Ignacio Moreno, María Ángeles Ferre, Ana María Moret, Juan Frasquet, Patricio Favier, Javier Pemán, Maria Jesus Castaño-Aroca, Paula Muñoz Brell, Mónica Gordon, Maria Dolores Gomez-Ruiz, and Miguel Salavert-Lleti
, Eva Calabuig, María Tasias, Víctor García Bustos, Ignacio Moreno, María Ángeles Ferre, Ana María Moret, Juan Frasquet, Patricio Favier, Javier Pemán, Maria Jesus Castaño-Aroca, Paula Muñoz Brell, Mónica Gordon, Maria Dolores Gomez-Ruiz, and Miguel Salavert-Lleti
Table 1
Baseline characteristics of patients with Candidozyma auris candidemia in study of metastatic C. auris infection, Spain, 2016–2024*
| Variable | Total, N = 108 | Metastatic infection absent, n = 84 | Metastatic infection present, n = 24 | p value |
|---|---|---|---|---|
| Age, y, median (IQR) |
60.6 (48.9-72.0) |
59.7 (43.9–70.7) |
68.9 (54.4–75.5) |
0.065 |
| Charlson Comorbidity Index, median (IQR) |
5 (3–7.2) |
5 (2.8–7.2) |
5.5 (3–7.2) |
0.465 |
| Sex | 0.757 | |||
| M | 76 (70.4) | 58 (69) | 18 (75) | |
| F |
32 (29.6) |
26 (31) |
6 (25) |
|
| Surgery in the past 30 d |
44 (40.7) |
30 (35.7) |
14 (58.3) |
0.080 |
| Previous therapy | ||||
| Broad-spectrum antibiotics | 100 (92.6) | 80 (95.2) | 20 (83.3) | 0.071 |
| Previous antifungal treatment | 30 (27.8) | 25 (29.8) | 5 (20.8) | 0.547 |
| Corticosteroid therapy | 21 (19.4) | 14 (16.7) | 7 (29.2) | 0.284 |
| Other immunosuppressive therapy |
18 (16.7) |
14 (16.7) |
4 (16.7) |
Referent |
| Risk factors | ||||
| Persistent candidemia | 34 (31.5) | 23 (27.4) | 11 (45.8) | 0.142 |
| Duration of candidemia, d, median (IQR) | 1 (1–8) | 1 (1–5) | 6 (1–38) | 0.034 |
| Central venous catheter | 93 (86.1) | 72 (85.7) | 21 (87.5) | Referent |
| Previous multisite colonization | 81 (75) | 64 (76.2) | 17 (70.8) | 0.789 |
| Parenteral nutrition | 68 (63) | 53 (63.1) | 15 (62.5) | Referent |
| Invasive mechanical ventilation | 52 (48.1) | 37 (44) | 15 (62.5) | 0.173 |
| Cardiac device/prosthetic valve | 35 (32.4) | 22 (26.2) | 13 (54.2) | 0.020 |
| Prosthetic heart valve | 18 (51.4) | 12 (54.5) | 6 (46.2) | |
| PPM/ICD | 15 (42.9) | 10 (45.5) | 5 (38.5) | |
| Left ventricular assist device | 2 (5.7) | 0 (0) | 2 (15.4) | |
| Solid organ transplant | 6 (5.6) | 3 (3.6) | 3 (12.5) | 0.122 |
| Severe sepsis | 24 (22.2) | 19 (22.6) | 5 (20.8) | Referent |
| Osteoarticular prosthesis | 15 (13.9) | 11 (13.1) | 4 (16.7) | 0.739 |
| Hemodialysis | 15 (13.9) | 11 (13.1) | 4 (16.7) | 0.739 |
| Previous candidemia | 10 (9.3) | 6 (7.1) | 4 (16.7) | 0.224 |
| Profound neutropenia, <500 cells/mL | 7 (6.5) | 4 (4.8) | 3 (12.5) | 0.182 |
| Concomitant bacteriemia |
6 (5.6) |
6 (7.1) |
0 (0) |
Referent |
| Admission department | ||||
| Surgical intensive care unit | 57 (52.8) | 47 (56) | 10 (41.7) | 0.460 |
| Medical intensive care unit | 21 (19.4) | 15 (17.9) | 6 (25) | |
| Other |
30 (27.8) |
22 (26.2) |
8 (33.3) |
|
| Management approach to candidemia | ||||
| Catheter removed within 48 h | 58 (53.7) | 44 (52.4) | 14 (58.3) | 0.777 |
| Non-catheter focus resolution within 48 h | 19 (17.6) | 16 (19) | 3 (12.5) | 0.557 |
| Cardiac echocardiography performed | 74 (68.5) | 53 (63.1) | 21 (87.5) | 0.026 |
| Fundoscopic examination performed |
74 (68.5) |
54 (64.3) |
20 (83.3) |
0.087 |
| Initial antifungal therapy | ||||
| Antifungal therapy within 48 h | 90 (83.3) | 72 (85.7) | 18 (75) | 0.352 |
| Echinocandin monotherapy | 81 (75) | 66 (78.6) | 15 (62.5) | 0.181 |
| Amphotericin B monotherapy | 3 (2.8) | 1 (1.2) | 2 (8.3) | 0.123 |
| Isavuconazole monotherapy | 1 (0.9) | 1 (1.2) | 0 (0) | Referent |
| Initial dual antifungal therapy | 23 (21.3) | 16 (19) | 7 (29.2) | 0.432 |
| Echinocandin + isavuconazole | 11 (10.2) | 7 (8.3) | 4 (16.7) | 0.258 |
| Echinocandin + amphotericin B |
12 (11.1) |
9 (10.7) |
3 (12.5) |
0.727 |
| Outcome | ||||
| Duration of antifungal therapy, d, median (IQR) | 26.5 (15–35.2) | 23 (15.0–32.2) | 43 (4.0–72.2) | <0.001 |
| Length of hospital stay after candidemia, d, median (IQR) | 23 (15.5–42.5) | 22.5 (15.2–29.8) | 47 (16.0–66.0) | 0.052 |
| Deaths within 30 d | 37 (34.3) | 32 (38.1) | 5 (20.8) | 0.184 |
| Deaths within 60 d | 44 (40.7) | 36 (42.9) | 8 (33.3) | 0.547 |
| Deaths within 90 d | 50 (46.3) | 40 (47.6) | 10 (41.7) | 0.777 |
*Values are no. (%) except as indicated. ICD, implantable cardioverter-defibrillators; IQR, interquartile range Q1–Q3; PPM, permanent pacemakers.
1These authors contributed equally to this work and are co–first authors.
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