Candida Auris Urinary Tract Infection in a Nursing Home Patient With Multicomorbidities.

Mirian V Garcia Rivera,Michael C Oh,Jonathan J Heyl

doi:10.7759/cureus.12322

Mirian V Garcia Rivera, Michael C Oh + Show 1 more

Open Access

https://doi.org/10.7759/cureus.12322

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Abstract

Candida (C.) auris is an opportunistic ascomycetous budding yeast that has been emerging as an invasive, multidrug-resistant pathogen over the past 11 years since its discovery. Candida auris infection has raised considerable attention in public health organizations due to its rising number of cases, virulence, and unique resistance to commonly used mycofungal therapy. This case follows a 64-year-old male with multiple comorbidities from the nursing home presenting with polybacterial sepsis along with a urinary tract infection growing Candida auris. Along with treatment for sepsis, the patient was placed on the Centers for Disease Control and Prevention's (CDC’s) recommended regimen of micafungin to eradicate C. auris infection and isolation precautions. Cases should be approached carefully and reported to public agencies such as the CDC and state health department.

Highlights

Candida (C.) auris is an opportunistic ascomycetous budding yeast that has been emerging as an invasive, multidrug-resistant pathogen over the past 11 years since its discovery
As of June 30, 2020, the total number of cases of C. auris recorded by the Centers for Disease Control and Prevention (CDC) in the United States totaled 1208
Another study found that select isolates of C. auris were resistant to the common last resort drug amphotericin B at a rate of up to 35% [3]

Summary

Introduction

Candida (C.) auris is an opportunistic ascomycetous budding yeast that has been emerging as an invasive, multidrug-resistant pathogen over the past 11 years since its discovery. Suspected sources of infection were thought to be from the urinary tract, decubitus ulcer, and otitis media This patient was initially treated with aggressive intravenous fluid resuscitation and empiric antibiotic treatment for sepsis, which included vancomycin and Azactam (due to penicillin allergy). The Foley catheter was changed, and he had surgical debridement of his ulcerations along with wound care daily This patient was considered high risk for Candida infection due to his indwelling Foley catheter, nursing home status, and several prior admissions, including one to the critical care unit. He was medically stabilized and discharged two weeks later

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