Natural clearance time and effect of manuka honey body wash and oral probiotics on colonization of Candidozyma auris (Candida auris) among residents of older adults homes in Hong Kong.

BACKGROUND: Candidozyma auris (C. auris) has emerged globally as a multidrug-resistant healthcare-associated fungal pathogen and is most commonly associated with bloodstream infections, which have high global mortality rates. However, little is known about the natural clearance time and effectiveness of decolonization therapy. We reported the natural clearance duration of C. auris and assessed whether decolonization using manuka honey baths and oral probiotics containing Lactobacillus rhamnosus GG and Saccharomyces boulardii can reduce colonization time. METHODS: We reviewed the demographic characteristics and outcomes of C. auris cases staying in RCHE in Hong Kong from 1 June 2019, when they were cleared of the fungus or died during the follow-up period up to 31 December 2024. Clearance of C. auris was defined as culture negative for at least three consecutive specimens collected monthly at the RCHE. We compared the clearance time of C. auris with and without decolonization using Kaplan-Meier methods. RESULTS: A total of 215 cases and 190 controls were analyzed with no major differences in demographic characteristics. The Kaplan-Meier analysis estimated that the median time until 50% of RCHE residents cleared C. auris colonization was 224 days for the intervention group and 427 days for the control group. The cases and controls showed no statistical difference in C. auris clearance duration. CONCLUSION: The long natural clearance time for C. auris poses pressure on infection control practices in RCHE. Further research in randomized controlled trials and other treatment modalities is encouraged to reduce its transmission.