Candida auris infection in a palestinian tertiary hospital: 36-patient retrospective cohort with high mortality

Data on Candida auris from Palestine are lacking. Clinical characteristics and in-hospital mortality were described. A retrospective cohort analysis from January 2019 to December 2024 was conducted at An-Najah National University Hospital. Included were all patients with laboratory-confirmed C. auris . Fisher’s exact test was employed for univariate comparisons. A total of 36 patients with laboratory-confirmed C. auris infection were included; mean age was 54 ± 19.9 years and 69% were female. ICU admission occurred in 89% of patients, with a median ICU stay of 32 days [IQR 18–58]. Central venous catheters, urinary catheters, and mechanical ventilation were present in 81%, 75%, and 72%, respectively. Infection sites included the urinary tract (56%), respiratory tract (50%), bloodstream (33%), and wound (17%); some patients had multiple sites. Septic shock occurred in 89%. Definitive therapy included azoles (50%), amphotericin B (44%), and echinocandins (14%). All-cause in-hospital mortality was 50%. On univariate analysis, respiratory tract isolation (crude OR 8.2, 95% CI 1.4–47.3; p = 0.008) and septic shock ( p = 0.034) were more frequent among non-survivors. These findings are exploratory and hypothesis-generating given the small sample size. All-cause in-hospital mortality was 50% in this Palestinian cohort of patients with clinically defined C. auris infection. Septic shock and respiratory tract isolation were associated with mortality on univariate analysis; these findings should not be interpreted as independent predictors or causal relationships. Among patients with confirmed clinical infection, echinocandin use was 14% and azole use was 50%; these prescribing patterns represent potential stewardship targets that warrant further investigation. Prospective, multicenter studies are needed.