Candida auris Colonization in Hospitalized Patients at a Tertiary Care Center in Saudi Arabia: Clinical Characteristics, Predictors, and Outcomes

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ID: 319615
2026
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Abstract
Abstract Background Candida auris (C. auris) is an emerging fungal pathogen of global concern. Data on its epidemiology in the Middle East remains limited. We characterized the clinical profile, predictors, and outcomes of C. auris colonization among hospitalized patients in Saudi Arabia. Methods A retrospective cohort study of 322 patients screened for C. auris between 2019 and 2025 at a tertiary care hospital in Riyadh. Patients were classified as C. auris–positive (n = 107) or –negative (n = 215). Baseline characteristics were compared using Mann-Whitney U and Fisher’s exact tests. Logistic regression identified predictors of positivity. Results The C. auris positivity rate was 33.2%, declining from 58.1% in 2021 to 24.8% in 2024 as surveillance expanded. Positive patients were older (median 70 vs. 59 years, p < 0.001) and had longer hospital stays (median 124 vs. 21 days, p < 0.001). Cardiovascular, endocrine, renal, and hematological comorbidities were significantly more prevalent. Age (per 10 years: OR 1.26, 95% CI 1.12–1.42) and length of stay (per 30 days: OR 1.20, 95% CI 1.12–1.28) were the strongest continuous predictors. All-cause in-hospital mortality was higher in positive patients (51.4% vs. 25.1%; OR 3.15, 95% CI 1.90–5.23, p < 0.001). Conclusion C. auris–positive patients exhibited advanced age, multimorbidity, prolonged hospitalization, and elevated all-cause mortality. These findings support targeted screening of high-risk populations in Gulf-region healthcare facilities.
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Authors Abdullah Awadh, Albaraa A Alsharif, Saad H Alahmari, Anmar A Bannani, Mazeed F Albogami, Assaf A Alzahrani, Abdulamajeed Y Ghazali
Journal Open forum infectious diseases
Year 2026
DOI
10.1093/ofid/ofag403
URL
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