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.

Highlights

  • Candida auris is an emerging multidrug-resistant yeast that is spreading rapidly worldwide [1]

  • C. auris is associated with nosocomial outbreaks, in intensive care settings, and transmission—despite the implementation of enhanced infection prevention and control (IPC) measures—is a particular concern [6,7]

  • Data were analysed for risk factors, microbiology, treatment, patient outcomes and infection control practices

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Summary

Introduction

Candida auris is an emerging multidrug-resistant yeast that is spreading rapidly worldwide [1]. Infections caused by Candida species including C. auris are commonly detected in patients with prolonged hospitalization, especially in intensive care units (ICUs) [2,3]. It causes diseases ranging from superficial skin infections to invasive bloodstream infections (BSI) with high mortality rates (30% to 60%) [4]. 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. Mainly an echinocandin, and source control are the prominent therapeutic approaches

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