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. 2022 Jun;65(6):613-624.
doi: 10.1111/myc.13447.

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

Kalaiselvi Vinayagamoorthy  1 , Kalyana Chakravarthy Pentapati  2 , Hariprasath Prakash  3
Affiliations

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

Kalaiselvi Vinayagamoorthy et al. Mycoses. 2022 Jun.

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 January 2020 to 31 December 2021.

Results: A total of 97 cases of C. auris were identified in COVID-19 patients. The pooled prevalence of C. auris infections (encompassing candidemia and non-candidemia cases) 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.

Keywords: Candida auris; COVID-19; candidemia; mortality; prevalence; systematic review.

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Conflict of interest statement

The authors declare no competing interest.

Figures

FIGURE 1
FIGURE 1
PRISMA flowchart describing the study selection process
FIGURE 2
FIGURE 2
Candida auris cases in COVID‐19 patients across countries. References are given in square brackets
FIGURE 3
FIGURE 3
Forest plot of pooled prevalence of Candida auris infections in COVID‐19 patients. "Frequency" denotes total number of C. auris cases and "Total" denotes total number of COVID‐19 infected patients. References are given in square brackets. Abbreviations: C.I, Confidence Interval
FIGURE 4
FIGURE 4
Forest plot of pooled survival estimates of (A) Candida auris non‐candidemia/colonised (CANC) and (B) Candida auris candidemia (CAC) cases in COVID‐19 patients. "Frequency" denotes total number of patients survived with C. auris infections and "Total" denotes total number of C. auris cases reported in each study.  References are given in square brackets. Abbreviations: C.I, Confidence Interval
See this image and copyright information in PMC

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