Impact of the COVID-19 Pandemic on Candida auris Infections: A Retrospective Analysis in an Academic Medical Center in New York City

Abstract Background Candida auris (C. auris), a multidrug-resistant fungus first described in Japan in 2009, has since spread rapidly around the world. More recently, cases of C. auris have increased substantially, which may have been affected by the strain the coronavirus disease 2019 (COVID-19) pandemic placed on health care resources. We describe the epidemiology of C. auris infection and colonization at a tertiary care hospital in New York City before, during, and after the peak of the COVID-19 pandemic and describe our approach to surveillance. Methods We performed a retrospective chart review for all incident cases of C. auris, defined as a patient without a known history of infection or colonization who had a positive surveillance or clinical culture detected at our institution from 2019 through 2022. Clinical and demographic data were collected using the electronic medical record. Results Sixty-four incident cases of C. auris were identified. Thirty-four of these were identified by surveillance and 30 by clinical culture. There was a statistically significant increase in the number of cases identified in 2022 compared with 2019, with incidence rates of 2.6 cases per 10 000 admissions in 2019 and 7.8 cases per 10 000 admissions in 2022 (p = .002), respectively. Conclusions The incidence of C. auris colonization or infection increased significantly at our institution during the COVID-19 pandemic, reflecting the potential impact the pandemic had on C. auris transmission. Targeted admission surveillance allows for the early identification of C. auris cases and can serve as a valuable tool to combat the increasing transmission of C. auris.