Global prevalence, mortality, and comorbidities of patients with diabetes mellitus and proven Candida auris emerging infection: a systematic review & meta-analysis

Abstract

Background: Candida auris is an emerging multidrug-resistant yeast pathogen with several risk factors, including diabetes mellitus (DM). This study analyzed the epidemiological aspects of C. auris patients with DM (CaDM). We searched related databases without time and linguistic limitations for studies reporting DM among patients with proven C. auris infection (PCaI). Methods: A meta-analysis was conducted using STATA (version 17) with the random-effects model based on DerSimonian and Laird methods, employing the metan and metaprop commands. Results: A total of 43 studies were included. Our random effect model reached the pooled prevalence of 36% (p value: < 0.001) for DM among patients with PCaI. The prevalence of DM among PCaI patients is almost 40% higher than non-auris patients (OR: 1.40; p value: < 0.001). Men with DM were 46% lower susceptibility to C. auris infection compared to women (OR: 0.54; p value: 0.905). However, this was not statistically significant. Our results showed that 57% of unadjusted all-cause mortality were recorded among CaDM patients (p value: 0.03). Chronic kidney diseases (CKD), hypertension (HTN), and respiratory diseases (RD) were the most frequent comorbidities. Central venous catheter (CVC), ICU stay, and mechanical ventilation were the most frequent hospital-related factors. Conclusions: We concluded that despite the significant advances in diagnosis and treatments, prevalence, risk, and mortality rates of C. auris infection and diabetes mellitus remained high.