Candida auris is a pathogen of growing public health concern worldwide. However, risk factors contributing to C. auris infection in patients colonized with C. auris remain unclear. Understanding these risk factors is crucial to prevent colonization-to-infection transition and devise effective preventive strategies. This study aimed to investigate risk factors associated with C. auris infection compared to colonization. The study included 97 patients who acquired laboratory-confirmed C. auris in either matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry or VITEK 2 system from October 2019 to June 2023. Baseline demographics and known risk factors associated with C. auris infection were collected from electronic medical records. The infection group had C. auris from a sterile site, or non-sterile site with evidence of infection. The colonization group were followed up for a median of 30 days for any signs of infection. Associations between relevant variables and C. auris infection were assessed using multivariable logistic regression. The infection group (n=31) was more likely to be bedbound, with longer hospital stays and more arterial catheters. Chronic kidney disease (odds ratio [OR] 45.070), carriage of multidrug-resistant organisms (OR 64.612), and vasopressor use more than 20 days (OR 68.994) were associated with C. auris infection, after adjusting for sex, age, and prior colonization with C. auris. Chronic kidney disease, carriage of multidrug-resistant organisms, and prolonged vasopressor use emerged as significant risk factors for C. auris infection compared to colonization. They could be used to predict C. auris infection early in patients colonized with C. auris. Identifying risk factors for Candida auris infection should be an essential component of care in patients colonized with C. auris. Chronic kidney disease, carriage of multidrug-resistant organisms, and prolonged vasopressor use emerged as significant risk factors for C. auris infection.
Objective. Higher breast density is a strong, independent risk factor for breast cancer. Breast density varies by age, ethnicity, and geographic area although dense breast tissue has been associated with younger age and premenopausal status. The relationship between breast density and age in women in the United Arab Emirates (UAE) has not been determined. This study evaluated breast density in the UAE population and its relationship with age. Methods. Women participating in the national cancer screening program from August 2015 to May 2018 who underwent screening mammography were included. Breast parenchymal density was classified according to the American College of Radiology (ACR) Breast Imaging-Reporting and Data System (BI-RADS) from category a (almost entirely fatty) through d (extremely dense). Subjects were divided into six age groups, and the association between age and breast density was evaluated. Results. Of the 4911 women included, 1604 (32.7%), 2149 (43.8%), 1055 (21.5%), and 103 (2.1%) were classified as having categories a–d breast density, respectively. A significant negative correlation was observed between age and breast density category (). Women of mean age 44 ± 7 years had the highest breast density, whereas those of mean age 56 ± 14 years had the lowest breast density. Comparisons of Emirati women with Lebanese and Western women showed that breast density was lower in Emirati women than in the other populations. Conclusions. To our knowledge, this is the first study to evaluate the relationship between mammographic breast density and age in UAE women. As in other populations, age was inversely related to breast density, but the proportion of Emirati women with dense breasts was lower than in other populations. Because this study lacked demographic, clinical, and histopathological data, further evaluation is required.
9 January 2025 in Journal of Infection and Public Health
Background: Candida auris screening is one of the crucial components of infection prevention and control measures to curb the spread of C. auris. However, previous research has yielded various results on the effectiveness of C. auris screening according to region, type of healthcare facility, and patient group in the various levels of endemicity. We aimed to assess the clinical effectiveness of routine C. auris screening upon admission to the intensive care unit (ICU). Methods: This retrospective study involved 3356 ICU patients during pre-screening (N = 1658, June 2020 to November 2021) and post-screening period (N = 1698, June 2022 to November 2023). Swabs for C. auris screening were taken from axilla and groin, then cultured, and identified using either matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry or VITEK 2 YST identification card. We compared the positivity rates of C. auris during the pre- and post-screening period. Results: Of the 1698 patients who underwent C. auris screening, only 4 (0.2 %) tested positive. The positivity rates before and after the introduction of the screening program were 2.92 cases per 1000 patient days (36/ 12333) and 2.36 (21/8909), respectively, without significant difference (P = 0.435). Interrupted times series analysis showed no immediate (P = 0.775) or sustained (P = 0.484) effects from the screening program. Subgroup analysis of patients in the medical ICU showed similar results. Conclusions: Universal C. auris screening upon ICU admission identified a small number of cases. Instead, targeted screening and regular point prevalence surveys, along with other infection prevention and control measures may be employed. Further studies in various settings with diverse testing strategies are needed to establish the most effective approach for C. auris screening. (c) 2025 The Author(s). Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have played a crucial role in mitigating the coronavirus disease 2019 (COVID-19) pandemic. However, few studies have addressed the optimal booster vaccine type in recipients of the primary series of BBIBP-CorV (an inactivated virus vaccine developed by Sinopharm). This study aimed to estimate the association between the heterologous or homologous COVID-19 vaccination and SARS-CoV-2 infection. The study enrolled healthcare personnel (HCP) who had completed two doses of BBIBP-CorV between November 2020 and September 2021. The associations between SARS-CoV-2 infection and boosters were measured using multivariable logistic regression, comparing the odds of a positive COVID-19 test result between the no booster group and booster groups (BNT162b2 {Pfizer-BioNTech COVID-19 vaccine} group and BBIBP-CorV group, respectively). A total of 495 HCP comprising 326 (65.9%) in the BNT162b2 group, 121 (24.4%) in the no booster group, and 48 (9.7%) in the BBIBP-CorV group enrolled. One hundred thirty-six cases (27.5%) tested positive for COVID-19. The odds ratios for testing positive after booster dose were 0.401 (95% CI: 0.187-0.860, p = 0.019) and 0.446 (95% CI: 0.170-1.167, p = 0.100) for BNT162b2 and BBIBP-CorV group, respectively. The BNT162b2 booster in HCP after a second dose of BBIBP-CorV, relative to no booster, and the BBIBP-CorV booster, was associated with protection against laboratory-confirmed COVID-19.
28 November 2023 in Antimicrobial Resistance & Infection Control
Multidrug-resistant organism (MDRO) screening may identify high-risk patients for MDRO infection and curb the spread of these resistant pathogens. However, the heterogeneous practices in MDRO screening and the diversity of MDRO risk factors necessitate a tailored approach for successful implementation. This study aimed to evaluate the performance of tailored MDRO screening in predicting MDRO carriage compared to universal screening. Critically ill patients who underwent MDRO screening tests upon intensive care unit admission between September 2015 and December 2019 were included in the study. A risk-predicting model was developed using risk factors identified through multivariable logistic regression analysis. If an individual had one or more identified risk factors, the individual was deemed to be at risk of MDRO carriage and undergo tailored screening. The sensitivity of tailored screening was compared with universal screening for methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant Gram-negative bacilli (carbapenem-resistant Acinetobacter baumannii and carbapenem-resistant Enterobacterales). The use of tracheostomy or endotracheal tubes, previous antibiotic exposure, previous multidrug-resistant Gram-negative bacilli carriage history, admission to the medical department, peripheral vascular disease, and liver disease were associated with positive screening for multidrug-resistant Gram-negative bacilli. These six risk factors accounted for all positive screening for multidrug-resistant Gram-negative bacilli, requiring 38.6% of all tests. Notably, MRSA had different risk factor profiles, and the risk factor-based screening approach detected only 43.1% (31 out of 72) of MRSA-positive cases. Tailored screening based on identified risk factors showed variable sensitivities to individual MDROs compared to universal screening. A tailored screening approach for individual MDROs may enhance the overall effectiveness of MDRO screening programs.
Candidozyma auris (formerly Candida auris) is frequently multidrug-resistant, resulting in limited treatment options and high mortality. Comparable mortality between C. auris candidemia and non-C. auris candidemia in recent studies requires confirmation in the Middle East after adjustment for confounders. This study aimed to compare mortality rates between patients with candidemia by C. auris and non-C. auris Candida species. We retrospectively analyzed 94 cases with candidemia between January 2019 and October 2025, including C. auris candidemia (n = 30) and non-C. auris candidemia (n = 64). Inverse probability weighting was used to balance baseline confounders between groups. The primary analysis used a weighted Cox proportional hazards model. Patients in the C. auris group had more comorbidities, greater healthcare exposure, and longer hospital stays. Crude 30-day all-cause cumulative mortality was comparable between the C. auris and non-C. auris groups (log-rank test, p = 0.8). The 30-day mortality of C. auris candidemia was similar to that of non-C. auris candidemia (adjusted HR 0.40; 95% CI 0.16–1.04; p = 0.060). Large multicenter studies involving diverse populations across different regions are warranted to validate these findings.