Alba Ruiz-Gaitán1,2, Héctor Martínez3, Ana María Moret4, Eva Calabuig5, María Tasias5, Ana Alastruey-Izquierdo6, Óscar Zaragoza6, Joan Mollar3, Juan Frasquet2, Miguel Salavert-Lletí5, Paula Ramírez7, José Luis López-Hontangas2, Javier Pemán1,2. 1. a Severe Infection Research Group, Medical Research Institute La Fe , Valencia , Spain. 2. f Department of Clinical Microbiology , La Fe University and Polytechnic Hospital , Valencia , Spain. 3. b Preventive Medicine Department , La Fe University and Polytechnic Hospital , Valencia , Spain. 4. c Anesthesiology and Surgical Critical Care Department , La Fe University and Polytechnic Hospital , Valencia , Spain. 5. d Infectious Diseases Department , La Fe University and Polytechnic Hospital , Valencia , Spain. 6. e Mycology Reference Laboratory , National Centre for Microbiology, Instituto de Salud Carlos III. Majadahonda , Madrid , Spain. 7. g Department of Critical Care , La Fe University and Polytechnic Hospital , Valencia , Spain.
Abstract
BACKGROUND: Candida auris is an emerging, multidrug-resistant yeast causing hospital outbreaks. This study describes the first 24 months of the ongoing C. auris outbreak in our hospital and analyzes predisposing factors to C. auris candidemia/colonization. RESEARCH DESIGN AND METHODS: A 12-month prospective, case-controlled study was performed including a total of 228 patients (114 colonized/candidemia and 114 controls). Data from the first 79 candidemia episodes and 738 environmental samples were also analyzed. Definitive C. auris identification was performed by ITS sequencing. Antifungal susceptibility was carried out by EUCAST methodology. RESULTS: Polytrauma (32%), cardiovascular disease (25%), and cancer (17%) were the most common underlying condition in colonized/candidemia patients. Indwelling CVC (odds ratio {OR}, 13.48), parenteral nutrition (OR, 3.49), and mechanical ventilation (OR, 2.43) remained significant predictors of C. auris colonization/candidemia. C. auris was most often isolated on sphygmomanometer cuffs (25%) patient tables (10.2%), keyboards (10.2%), and infusion pumps (8.2%). All isolates were fully resistant to fluconazole (MICs >64 mg/L) and had significantly reduced susceptibility to voriconazole (GM, 1.8 mg/L). CONCLUSIONS: Predictor conditions to C. auris colonization/candidemia are similar to other Candida species. C. auris colonizes multiple patient's environment surfaces. All isolates are resistant to fluconazole and had significant reduced susceptibility to voriconazole.
BACKGROUND:Candida auris is an emerging, multidrug-resistant yeast causing hospital outbreaks. This study describes the first 24 months of the ongoing C. auris outbreak in our hospital and analyzes predisposing factors to C. auris candidemia/colonization. RESEARCH DESIGN AND METHODS: A 12-month prospective, case-controlled study was performed including a total of 228 patients (114 colonized/candidemia and 114 controls). Data from the first 79 candidemia episodes and 738 environmental samples were also analyzed. Definitive C. auris identification was performed by ITS sequencing. Antifungal susceptibility was carried out by EUCAST methodology. RESULTS:Polytrauma (32%), cardiovascular disease (25%), and cancer (17%) were the most common underlying condition in colonized/candidemiapatients. Indwelling CVC (odds ratio {OR}, 13.48), parenteral nutrition (OR, 3.49), and mechanical ventilation (OR, 2.43) remained significant predictors of C. auris colonization/candidemia. C. auris was most often isolated on sphygmomanometer cuffs (25%) patient tables (10.2%), keyboards (10.2%), and infusion pumps (8.2%). All isolates were fully resistant to fluconazole (MICs >64 mg/L) and had significantly reduced susceptibility to voriconazole (GM, 1.8 mg/L). CONCLUSIONS: Predictor conditions to C. auris colonization/candidemia are similar to other Candida species. C. auris colonizes multiple patient's environment surfaces. All isolates are resistant to fluconazole and had significant reduced susceptibility to voriconazole.
Authors: Wadha Alfouzan; Suhail Ahmad; Rita Dhar; Mohammad Asadzadeh; Noura Almerdasi; Naglaa M Abdo; Leena Joseph; Theun de Groot; Walid Q Alali; Ziauddin Khan; Jacques F Meis; Mohammad R Al-Rashidi Journal: J Fungi (Basel) Date: 2020-11-21