Prevalence, risk factors, treatment and outcome of multidrug resistance Candida auris infections in Coronavirus disease (COVID‐19) patients: A systematic review

Abstract

Background Candida auris is an emerging multidrug‐resistant pathogen in intensive care settings (ICU). During the coronavirus disease 19 (COVID‐19) pandemic, ICU admissions were overwhelmed, possibly contributing to the C. auris outbreak in COVID‐19 patients. Objectives The present systematic review addresses the prevalence, underlying diseases, iatrogenic risk factors, treatment and outcome of C . auris infections in COVID‐19 patients. Methods MEDLINE, Scopus, Embase, Web of Science and LitCovid databases were systematically searched with appropriate keywords from 1 st January 2020 to 31 st December 2021. Results A total of 97 cases of C. auris were identified in COVID‐19 patients. The prevalence of C. auris infections in COVID‐19 patients was 14%. The major underlying diseases were diabetes mellitus (42.7%), hypertension (32.9%), and obesity (14.6%), followed by the iatrogenic risk factors such as a central venous catheter (76.8%%) intensive care unit (ICU) stay (75.6%), and broad‐spectrum antibiotic usage (74.3%). There were no significant differences in underlying disease and iatrogenic risk factors among C. auris non‐candidemia/colonisation and C. auris candidemia cases. The mortality rate of the total cohort is 44.4%, whereas, in C. auris candidemia patients, the mortality was 64.7%. Conclusion This study shows that the prevalence of C. auris infections remains unchanged in the COVID‐19 pandemic. Hospital‐acquired risk factors may contribute to the clinical illness. Proper infection control practices and hospital surveillance may stop future hospital outbreaks during the pandemic.

Occurrence of Candidemia in Patients with COVID-19 Admitted to Five ICUs in France

“…Contrary to a previous study by Machado et al, only one isolate was found that was resistant to antifungal drugs [4]. Similarly, Candida auris, whose first described case occurred in our institution [20], was not found, although its incidence is high in some studies [21]. More strikingly, we did not observe any candidemia due to C. glabrata.…”

Global prevalence and subgroup analyses of coronavirus disease (COVID‐19) associated Candida auris infections (CACa): A systematic review and meta‐analysis

“… 9 , 54 However, there are several descriptive studies. 11 , 12 , 17 , 18 , 19 , 55 , 56 , 57 Although a recent study published by Indian researchers 58 reported a 14% pooled prevalence rate for CACa cases, it does not seem logical to compare their results with our study for various reasons. One of these reasons is the inclusion of case reports and case series (for instance, Mexico and Lebanon) in their final analysis, despite current guidelines for prevalence and incidence data.…”

Genome-wide scan for potential CD4+ T-cell vaccine candidates in Candida auris by exploiting reverse vaccinology and evolutionary information

“…Coronavirus-associated Candida infection (CACa) is the third most prevalent fungal disease associated with SARS-CoV-2, with a high mortality rate of 67.849% ( 91 ). However, it is necessary to state that the majority of these patients also had other complications or diseases, such as diabetes mellitus, hypertension, or obesity ( 93 ). Therefore, due to lack of documentation, it is unclear whether C. auris infection alone was responsible for the higher mortality rate or other risk factors significantly contributed toward it.…”