Candida auris: outbreak fungal pathogen in COVID-19 pandemic: a systematic review and meta-analysis

Kamran  Bagheri Lankarani; Maryam Akbari; Reza Tabrizi; Mohebat Vali; Eghbal Sekhavati; Seyed Taghi Heydari; Hossein Khodadadi; Fariba Ahmadizar

doi:10.18502/ijm.v14i3.9753

Kamran Bagheri Lankarani Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
Maryam Akbari Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
Reza Tabrizi Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
Mohebat Vali Department of Epidemiology, Shiraz University of Medical Sciences, Shiraz, Iran
Eghbal Sekhavati Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
Seyed Taghi Heydari Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
Hossein Khodadadi Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
Fariba Ahmadizar Julius Global Health, University Utrecht Medical Center, Utrecht, The Netherlands

DOI: https://doi.org/10.18502/ijm.v14i3.9753

Keywords: Candida auris infection; COVID-19; Disease outbreaks; Meta-analysis

Abstract

Background and Objectives: Candida auris (C. auris) is the first fungal pathogen considered a global health threat. Be- cause, C. auris is associated with multidrug resistance and associated diseases such as diabetes, sepsis, lung and kidney disease. This study investigated the prevalence and mortality of C. auris infection during Covid-19 pandemic.

Materials and Methods: Databases were searched for peer-reviewed articles published in the English language up to Jan 18, Heterogeneity across studies was evaluated using Cochrane’s Q test and the I2 index. The pooled point prevalences and their corresponding 95% confidence interval (CIs) were estimated usingthe random-effects model.

Results: In our meta-analysis, 11 eligible articles were included. The total pooled prevalence estimation of C. auris infection among COVID-19 patients was 13% (95% CI: 8%, 19%). The estimated pooled mortality rate of C. auris infection was 37% (95% CI: 15%, 61%). In terms of specific conditions, the pooled risk of mortality was higher in people with diabetes 65% (95% CI: 0.45%, 83%), in cases with >21 days admission inintensive care unit (ICU) 44% (95% CI: 21%, 0.68%), and after receiving steroids 43% (95% CI: 18%, 69%).

Conclusion: Our study highlights the high prevalence rate of C. auris infection, particularly among people with a history of metabolic disorders.