Absence of community-acquired Candida auris colonization among newly hospitalized participants without recent healthcare exposure from a cross-sectional study in Dhaka, Bangladesh

ABSTRACT Candida auris (C. auris), an emerging fungus, is primarily recognized for causing healthcare-associated infections. While carriage among hospitalized patients is well documented, community spread remains poorly understood. This study aimed to determine the burden of community-acquired C. au...

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Main Authors: Gazi Md. Salahuddin Mamun, Tanzir Ahmed Shuvo, Sanzida Khan, Syeda Mah-E-Muneer, Md. Aminul Islam, Dilruba Ahmed, Kabid Ahmed, Debashis Sen, Kamal Hossain, Md. Nazmul Islam, Aninda Rahman, Mohammad Monir-Uz-Zaman, Md. Mustafizur Rahman, Fahmida Naz Mustafa, Md. Salim, Rubina Yasmin, Md. Shafiur Rahman, Tarak Nath Kundu, Mostafa Kamal, Farzana Sohael, Sakina Shab Afroz, Mahmudur Rahman, Fahmida Chowdhury
Format: Article
Language:English
Published: American Society for Microbiology 2025-07-01
Series:Microbiology Spectrum
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Online Access:https://journals.asm.org/doi/10.1128/spectrum.00393-25
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author Gazi Md. Salahuddin Mamun
Tanzir Ahmed Shuvo
Sanzida Khan
Syeda Mah-E-Muneer
Md. Aminul Islam
Dilruba Ahmed
Kabid Ahmed
Debashis Sen
Kamal Hossain
Md. Nazmul Islam
Aninda Rahman
Mohammad Monir-Uz-Zaman
Md. Mustafizur Rahman
Fahmida Naz Mustafa
Md. Salim
Rubina Yasmin
Md. Shafiur Rahman
Tarak Nath Kundu
Mostafa Kamal
Farzana Sohael
Sakina Shab Afroz
Mahmudur Rahman
Fahmida Chowdhury
author_facet Gazi Md. Salahuddin Mamun
Tanzir Ahmed Shuvo
Sanzida Khan
Syeda Mah-E-Muneer
Md. Aminul Islam
Dilruba Ahmed
Kabid Ahmed
Debashis Sen
Kamal Hossain
Md. Nazmul Islam
Aninda Rahman
Mohammad Monir-Uz-Zaman
Md. Mustafizur Rahman
Fahmida Naz Mustafa
Md. Salim
Rubina Yasmin
Md. Shafiur Rahman
Tarak Nath Kundu
Mostafa Kamal
Farzana Sohael
Sakina Shab Afroz
Mahmudur Rahman
Fahmida Chowdhury
author_sort Gazi Md. Salahuddin Mamun
collection DOAJ
description ABSTRACT Candida auris (C. auris), an emerging fungus, is primarily recognized for causing healthcare-associated infections. While carriage among hospitalized patients is well documented, community spread remains poorly understood. This study aimed to determine the burden of community-acquired C. auris skin colonization among newly hospitalized participants without any recent healthcare exposure. This cross-sectional study was conducted at two tertiary-level government hospitals and their surrounding catchment areas in Dhaka, Bangladesh, from June 2023 to May 2024. We enrolled 800 participants (400 from each hospital) shortly after admission, meeting the following criteria: no healthcare exposure within the past three months, no invasive procedures performed since the current hospital admission, and residence within the hospital’s catchment area for the past three months. Skin swabs from the axillae and groins were cultured on CHROMagar Candida Plus to determine fungal colonization. Presumptive positive isolates were identified using VITEK 2, and C. auris was confirmed by whole-genome sequencing. No C. auris colonization was detected in the axillary or groin in any enrolled participant. However, 128 (16%) patients were found to be colonized with other fungal species. The absence of community-acquired C. auris colonization in this study suggests that transmission primarily occurs within hospital settings. However, our strict inclusion criteria, which excluded patients with recent healthcare exposure, may have influenced this finding. Further research using alternative study designs is needed to fully understand the potential for C. auris spread within the community.IMPORTANCECandida auris, a rapidly emerging multidrug-resistant fungal pathogen with high mortality, poses a critical global health threat, particularly in healthcare settings. While extensive research has focused on its colonization among hospitalized patients, its potential presence and community transmission remain largely unexplored. An earlier study among critically ill patients in Bangladesh detected four colonized cases of C. auris without hospitalization history within the past year and admitted directly from home (F. Chowdhury et al., unpublished data). Notably, three participants resided in the same district and one in an adjacent district, raising serious concerns about possible community spread. This study is crucial in addressing this knowledge gap by assessing the burden of community-acquired C. auris colonization among newly hospitalized patients in Dhaka. Understanding its potential transmission outside the hospital is vital for shaping public health responses, guiding infection control strategies, and strengthening global surveillance efforts to mitigate the spread of this highly resistant pathogen.
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spelling doaj-art-0df0cd82783446b297eefebf5995e7592025-08-20T03:16:00ZengAmerican Society for MicrobiologyMicrobiology Spectrum2165-04972025-07-0113710.1128/spectrum.00393-25Absence of community-acquired Candida auris colonization among newly hospitalized participants without recent healthcare exposure from a cross-sectional study in Dhaka, BangladeshGazi Md. Salahuddin Mamun0Tanzir Ahmed Shuvo1Sanzida Khan2Syeda Mah-E-Muneer3Md. Aminul Islam4Dilruba Ahmed5Kabid Ahmed6Debashis Sen7Kamal Hossain8Md. Nazmul Islam9Aninda Rahman10Mohammad Monir-Uz-Zaman11Md. Mustafizur Rahman12Fahmida Naz Mustafa13Md. Salim14Rubina Yasmin15Md. Shafiur Rahman16Tarak Nath Kundu17Mostafa Kamal18Farzana Sohael19Sakina Shab Afroz20Mahmudur Rahman21Fahmida Chowdhury22International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, BangladeshInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, BangladeshInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, BangladeshInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, BangladeshInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, BangladeshInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, BangladeshInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, BangladeshInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, BangladeshInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, BangladeshDirectorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, BangladeshDirectorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, BangladeshMugda Medical College Hospital, Dhaka, BangladeshMugda Medical College Hospital, Dhaka, BangladeshMugda Medical College Hospital, Dhaka, BangladeshMugda Medical College Hospital, Dhaka, BangladeshMugda Medical College Hospital, Dhaka, BangladeshShaheed Suhrawardy Medical College Hospital, Dhaka, BangladeshShaheed Suhrawardy Medical College Hospital, Dhaka, BangladeshShaheed Suhrawardy Medical College Hospital, Dhaka, BangladeshShaheed Suhrawardy Medical College Hospital, Dhaka, BangladeshShaheed Suhrawardy Medical College Hospital, Dhaka, BangladeshGlobal Health Development/EMPHNET (Eastern Mediterranean Public Health Network), Dhaka, BangladeshInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, BangladeshABSTRACT Candida auris (C. auris), an emerging fungus, is primarily recognized for causing healthcare-associated infections. While carriage among hospitalized patients is well documented, community spread remains poorly understood. This study aimed to determine the burden of community-acquired C. auris skin colonization among newly hospitalized participants without any recent healthcare exposure. This cross-sectional study was conducted at two tertiary-level government hospitals and their surrounding catchment areas in Dhaka, Bangladesh, from June 2023 to May 2024. We enrolled 800 participants (400 from each hospital) shortly after admission, meeting the following criteria: no healthcare exposure within the past three months, no invasive procedures performed since the current hospital admission, and residence within the hospital’s catchment area for the past three months. Skin swabs from the axillae and groins were cultured on CHROMagar Candida Plus to determine fungal colonization. Presumptive positive isolates were identified using VITEK 2, and C. auris was confirmed by whole-genome sequencing. No C. auris colonization was detected in the axillary or groin in any enrolled participant. However, 128 (16%) patients were found to be colonized with other fungal species. The absence of community-acquired C. auris colonization in this study suggests that transmission primarily occurs within hospital settings. However, our strict inclusion criteria, which excluded patients with recent healthcare exposure, may have influenced this finding. Further research using alternative study designs is needed to fully understand the potential for C. auris spread within the community.IMPORTANCECandida auris, a rapidly emerging multidrug-resistant fungal pathogen with high mortality, poses a critical global health threat, particularly in healthcare settings. While extensive research has focused on its colonization among hospitalized patients, its potential presence and community transmission remain largely unexplored. An earlier study among critically ill patients in Bangladesh detected four colonized cases of C. auris without hospitalization history within the past year and admitted directly from home (F. Chowdhury et al., unpublished data). Notably, three participants resided in the same district and one in an adjacent district, raising serious concerns about possible community spread. This study is crucial in addressing this knowledge gap by assessing the burden of community-acquired C. auris colonization among newly hospitalized patients in Dhaka. Understanding its potential transmission outside the hospital is vital for shaping public health responses, guiding infection control strategies, and strengthening global surveillance efforts to mitigate the spread of this highly resistant pathogen.https://journals.asm.org/doi/10.1128/spectrum.00393-25Candida aurisemerging funguscolonizationcommunity-acquiredBangladesh
spellingShingle Gazi Md. Salahuddin Mamun
Tanzir Ahmed Shuvo
Sanzida Khan
Syeda Mah-E-Muneer
Md. Aminul Islam
Dilruba Ahmed
Kabid Ahmed
Debashis Sen
Kamal Hossain
Md. Nazmul Islam
Aninda Rahman
Mohammad Monir-Uz-Zaman
Md. Mustafizur Rahman
Fahmida Naz Mustafa
Md. Salim
Rubina Yasmin
Md. Shafiur Rahman
Tarak Nath Kundu
Mostafa Kamal
Farzana Sohael
Sakina Shab Afroz
Mahmudur Rahman
Fahmida Chowdhury
Absence of community-acquired Candida auris colonization among newly hospitalized participants without recent healthcare exposure from a cross-sectional study in Dhaka, Bangladesh
Microbiology Spectrum
Candida auris
emerging fungus
colonization
community-acquired
Bangladesh
title Absence of community-acquired Candida auris colonization among newly hospitalized participants without recent healthcare exposure from a cross-sectional study in Dhaka, Bangladesh
title_full Absence of community-acquired Candida auris colonization among newly hospitalized participants without recent healthcare exposure from a cross-sectional study in Dhaka, Bangladesh
title_fullStr Absence of community-acquired Candida auris colonization among newly hospitalized participants without recent healthcare exposure from a cross-sectional study in Dhaka, Bangladesh
title_full_unstemmed Absence of community-acquired Candida auris colonization among newly hospitalized participants without recent healthcare exposure from a cross-sectional study in Dhaka, Bangladesh
title_short Absence of community-acquired Candida auris colonization among newly hospitalized participants without recent healthcare exposure from a cross-sectional study in Dhaka, Bangladesh
title_sort absence of community acquired candida auris colonization among newly hospitalized participants without recent healthcare exposure from a cross sectional study in dhaka bangladesh
topic Candida auris
emerging fungus
colonization
community-acquired
Bangladesh
url https://journals.asm.org/doi/10.1128/spectrum.00393-25
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