Rema A. Aldugiem

Background: Candidozyma auris has emerged globally as a multidrug-resistant pathogen with high rates of colonization and potential for invasive infection. Understanding the progression from colonization to infection and associated outcomes is limited. This study aimed to describe the characteristics and outcomes of C. auris-colonized patients and identify risk factors for progression to infection. Methods: We conducted a single-center retrospective case–control study of hospitalized patients with documented C. auris colonization at a tertiary care center (2018–2024). Cases were patients who progressed to a fungal infection (infection group), while controls remained colonized (colonized group). Demographics, comorbidities, device use, prior antimicrobial exposure, microbiologic characteristics, and outcomes were compared. Results: Among 334 C. auris-colonized patients, 44 (13.2%) progressed to infection. The median age was 66.4 years. Those in the infection group had higher Charlson Comorbidity Index (5.9 ± 3.1 vs. 4.79 ± 2.7, p = 0.0112) and were more likely to have central line (90.9% vs. 71.7%, p = 0.0067), mechanical ventilation (77.3% vs. 60.34%, p = 0.0306), parenteral nutrition (6.82% vs. 1.72%, p = 0.0395), and abdominal surgery (13.64% vs. 4.83%, p = 0.0217). In multivariate analysis, abdominal surgery was the only independent predictor of infection (OR 4.08; 95% CI 1.1–15.1; p = 0.03). In-hospital mortality was significantly higher in the infection group (65.9% vs. 33.1%, p < 0.0001). Conclusions: Approximately one in eight colonized patients developed C. auris infection. Recent abdominal surgery independently predicted progression, while infection was associated with higher mortality and prolonged hospitalization, underscoring the need for targeted prevention in high-risk patients.

Background: Brucellosis is a major zoonotic infection that warrants treatment with antibiotic therapy. Current treatment recommendations include using either dual or triple therapy with antibiotics active against brucella species. This study aims to evaluate the effectiveness and safety of dual and triple antibiotic therapy for treating brucellosis. Methods: This is a retrospective cohort study for patients with confirmed Brucellosis infection from 2015 to 2024. The primary outcome was the achievement of a favorable response. Secondary outcomes were treatment failure, 90-day mortality, relapse of brucella infection, hospital re-admission, and adverse drug reactions (ADRs). Baseline characteristics were reported as means with standard deviations. All the statistical tests are shown as odds ratios (ORs) with 95% confidence intervals (CIs). Results: In total, 966 patients were screened and 287 met the inclusion criteria: 164 patients in the dual therapy group and 123 patients in the triple therapy group. Achievement of a favorable response was not statistically different between the dual therapy and triple therapy groups; 87.3% vs. 90.5%, OR 1.2 (0.48–3.02, p = 0.42). No patient died in either treatment group. Treatment failure, mean duration of hospitalization, brucella relapse, hospital re-admission, and the mean time to defervescence were not statistically different between dual and triple therapy groups. Adverse drug reactions were numerically higher in the triple therapy group. Conclusions: Dual therapy was equally effective for the treatment of patients with brucellosis compared to the triple therapy regimens. Although not statistically significant, there more ADRs in the triple therapy group compared to those receiving dual therapy. Thus, dual antibiotic therapy is efficacious, less costly, and associated with fewer ADRs compared to triple antibiotic therapy.