Epidemiology and Outcomes of Candida auris Infections in Türkiye: A National Surveillance Study, 2023-2025.

BACKGROUND: Candida auris is a multidrug-resistant yeast classified by the World Health Organization as a critical priority fungal pathogen. Following the first case notified through the national surveillance system in February 2023, nationally notified infections have risen rapidly. We aimed to describe the epidemiology, risk factors, infection profiles, and outcomes of C. auris infections captured by the national healthcare-associated infection (HAI) surveillance system in Türkiye. METHODS: We analysed all C. auris infections reported to INFLINE, Türkiye's national HAI surveillance system, between 12 February 2023 and 31 December 2025. Variables included patient demographics, hospital and unit type, geographic distribution, invasive device exposures, infection type, co-pathogens, and discharge status. RESULTS: A total of 2,829 C. auris infections were reported from 54 of 81 provinces, with annual counts rising from 179 (2023) to 1,924 (2025). Most infections occurred in intensive care units (86.6%), predominantly as bloodstream infection (96.6%), of which 76.4% were central line-associated. C. auris was the sole pathogen in 81.1% of cases; 18.9% were polymicrobial. Common device exposures included urinary catheter (71.2%), central line catheter (66.4%), and mechanical ventilation (54.9%). In-hospital mortality was 49.8% overall; among those with a recorded outcome (n=1,894), 74.4%, with outcome data missing for 33.1% of cases. CONCLUSIONS: C. auris has rapidly established itself as a significant nosocomial pathogen in Türkiye, predominantly affecting critically ill ICU patients. National responses include publication of a prevention and control guide, strengthened diagnostic capacity, infection control committee training, and integration of C. auris into the National Antimicrobial Resistance Action Plan.