Key result
Cardiac devices or prosthetic valves linked to ~2.9-fold higher risk of metastatic Candidozyma auris infection.
Why the study?
Metastatic infection following Candidozyma auris candidemia was poorly characterized.
What are the incidence, clinical patterns, predictors (such as intracardiac devices or persistent candidemia), and mortality outcomes of metastatic infection in adult patients with Candidozyma auris candidemia?
Cohort (n=108)
No
What are the incidence, clinical patterns, predictors (such as intracardiac devices or persistent candidemia), and mortality outcomes of metastatic infection in adult patients with Candidozyma auris candidemia?
In patients with Candidozyma auris candidemia, metastatic infection occurs in 22.2% of cases—most commonly as endocarditis (7.4%)—is associated with increased 60- and 90-day mortality, and is independently predicted by the presence of intracardiac devices or prosthetic valves, supporting targeted echocardiographic screening.
Answers are grounded in this paper and cite their sources.
Cardiac devices or prosthetic valves were associated with higher metastatic C. auris risk; hypothesis-generating and requires prospective validation before changing practice.
Metastatic infection after Candidozyma auris candidemia remains poorly characterized. We retrospectively studied patients with C. auris candidemia at a tertiary hospital in Spain during 2016-2024. Of 108 patients, 24 (22.2%) experienced metastatic infections; endocarditis was most frequent (7.4%), followed by osteoarticular infection, meningitis, and hepatosplenic infection (3.7% each). In multivariable Fine-Gray regression, a cardiac device or prosthetic valve was independently associated with metastatic infection (subdistribution hazard ratio [HR] 2.89 [95% CI 1.21-6.91]), although that association was attenuated in a sensitivity analysis restricted to echocardiographed patients. Persistent candidemia showed a higher, nonsignificant risk for metastatic infection in the day-5 landmark analysis (subdistribution HR 2.67 [95% CI 0.86-8.32]). Metastatic infection was associated with increased deaths in time-dependent analyses at 60 days (adjusted HR 2.21 [95% CI 1.04-4.67]) and 90 days (adjusted HR 2.26 [95% CI 1.09-4.67]). Our findings support echocardiography in patients with intracardiac devices.
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Suárez-Urquiza et al. (2026) conducted a cohort in Candidozyma auris candidemia (n=108). Presence of a cardiac device or prosthetic valve vs. Absence of a cardiac device or prosthetic valve was evaluated on Diagnosis of metastatic Candidozyma auris infection (with death before diagnosis as a competing event) (sHR 2.89, 95% CI 1.21-6.91, p=0.017). Presence of a cardiac device or prosthetic valve was independently associated with a higher risk of metastatic Candidozyma auris infection (sHR 2.89, 95% CI 1.21-6.91, p=0.017).
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