International Multicentre Study of <i>Candida auris</i> Infections.


Creative Commons License

Pandya N., Cag Y., Pandak N., Pekok A. U. , Poojary A., Ayoade F., ...More

Journal of fungi (Basel, Switzerland), vol.7, no.10, 2021 (Peer-Reviewed Journal) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 7 Issue: 10
  • Publication Date: 2021
  • Doi Number: 10.3390/jof7100878
  • Journal Name: Journal of fungi (Basel, Switzerland)
  • Journal Indexes: Science Citation Index Expanded, Scopus, BIOSIS, Directory of Open Access Journals
  • Keywords: Candida, C. auris, fungi, outbreak, nosocomial, resistance, RESISTANT, MANAGEMENT, EMERGENCE

Abstract

Background:Candida auris has emerged globally as a multi-drug resistant yeast and is commonly associated with nosocomial outbreaks in ICUs. Methods: We conducted a retrospective observational multicentre study to determine the epidemiology of C. auris infections, its management strategies, patient outcomes, and infection prevention and control practices across 10 centres from five countries. Results: Significant risk factors for C. auris infection include the age group of 61-70 years (39%), recent history of ICU admission (63%), diabetes (63%), renal failure (52%), presence of CVC (91%) and previous history of antibiotic treatment (96%). C. auris was commonly isolated from blood (76%). Echinocandins were the most sensitive drugs. Most common antifungals used for treatment were caspofungin (40%), anidulafungin (28%) and micafungin (15%). The median duration of treatment was 20 days. Source removal was conductedin 74% patients. All-cause crude mortality rate after 30 days was 37%. Antifungal therapy was associated with a reduction in mortality (OR:0.27) and so was source removal (OR:0.74). Contact isolation precautions were followed in 87% patients. Conclusions: C. auris infection carries a high risk for associated mortality. The organism is mainly resistant to most azoles and even amphotericin-B. Targeted antifungal therapy, mainly an echinocandin, and source control are the prominent therapeutic approaches.