Metastatic infection identified in 22% of Spanish Candidozyma auris candidemia cohort

Researchers at Hospital Universitari i Politècnic La Fe in Valencia, Spain, retrospectively studied 108 adults with Candidozyma auris, formerly Candida auris, candidemia during 2016–2024. They assessed the frequency, patterns, and predictors of metastatic infection and its association with mortality, accounting for death as a competing event when evaluating dissemination.

Metastatic infection occurred in 24 patients (22.2%). Endocarditis affected eight patients (7.4%); osteoarticular infection, meningitis, and hepatosplenic infection each affected four (3.7%). A cardiac device or prosthetic valve was independently associated with metastatic infection (subdistribution hazard ratio 2.89, 95% CI 1.21–6.91), although this association weakened in an analysis restricted to patients who underwent echocardiography. Persistent candidemia showed a higher but statistically nonsignificant risk in a day-5 landmark analysis.

In time-dependent analyses adjusted for age and comorbidity, metastatic infection was associated with higher mortality at 60 days (hazard ratio 2.21, 95% CI 1.04–4.67) and 90 days (2.26, 1.09–4.67). The authors support echocardiography for patients with intracardiac devices. However, the retrospective, single-center design and sensitivity to echocardiographic evaluation limit interpretation of the predictor findings. The report is an early-release journal article and may change before final publication.