Candida auris Urinary Tract Colonization and Nosocomial Infection Control Strategies in Shanghai
Abstract
Background Candida auris is a multidrug-resistant pathogenic fungus that exhibits regional variation and is emerging in new clades worldwide. C. auris predominantly colonizes the urinary tract and respiratory system, thereby increasing the risk of bloodstream infection. Objective To evaluate the epidemiological characteristics of C. auris urinary tract colonization in Shanghai and assess the efficacy of prevention and control strategies using molecular epidemiology and clinical interventions to provide evidence-based guidance for hospital infection control. Methods Cases were identified using the ECIFIG Surveillance Network. C. auris isolates from urethral samples were cultured and identified by MALDI-TOF MS combined with ITS sequencing. Antifungal susceptibility was tested using microbroth dilution and YeastOne colorimetric assay. Whole-genome sequencing (WGS) was used to analyze mutations in drug resistance genes, and phylogenetic relationships were determined using SNP-based analysis. The patient received amphotericin B bladder irrigation combined with saline. Active surveillance screened close contacts, environmental surfaces, and hands of healthcare workers. The efficacy of various disinfectants on different surfaces was evaluated to optimize disinfection, and all interventions were guided by comprehensive risk assessment. Results Between April 2024 and April 2025, C. auris was isolated from the urine samples of 10 long-term bedridden patients with indwelling catheters…
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