Five-year profile of candidaemia at an Indian trauma centre: High rates of Candida auris blood stream infections.

Abstract

Candidaemia is a potentially fatal infection with varied distribution of Candida species and their antifungal susceptibility profiles. The recent emergence of Candida auris in invasive candidiasis is a cause for concern. This study describes the profile of candidaemia at an Indian tertiary care hospital and reports the emergence of C.auris. All patients diagnosed with candidaemia between 2012 and 2017 were studied. The isolates were identified using conventional methods, VITEK 2 and MALDI-TOF MS. The isolates not identified by MALDI-TOF were sequenced. Antifungal susceptibility testing was done by the CLSI broth microdilution method and VITEK 2. Atotal of 114 isolates of Candida species were analysed. Candida tropicalis (39.4%) was the most common species, followed by C.auris (17.5%), C.albicans (14%) and C.parapsilosis (11.4%). Notably, Diutina mesorugosa isolates (n=10) were not identified by MALDI-TOF and were confirmed by sequencing. Furthermore, 45% (n=9) C.auris strains exhibited low MICs of FLU (0.05-4μg/mL) and the remaining 55% (n=11) isolates had high MICs≥64μg/mL. Also, D.mesorugosa exhibited high MICs of FLU (32μg/mL) in 2 isolates. A high rate of errors in antifungal susceptibility was noted with the VITEK 2 as compared to the CLSI method. Candida auris was the second most prevalent species causing candidaemia warranting infection control practices to be strengthened to prevent its spread.