Prakash S Shastri1, Shamanth A Shankarnarayan2, Jaswinder Oberoi3, Shivaprakash M Rudramurthy4, Chand Wattal3, Arunaloke Chakrabarti5. 1. Critical Care & Emergency Medicine, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi 110060, India. Electronic address: prakashshastri@live.in. 2. Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India. 3. Dept of Clinical Microbiology & Immunology, GRIPMER, Sir Ganga Ram Hospital, New Delhi, India. 4. Professor, Department of Medical Microbiology, Postgraduate Institute of Medical Education & Research, Chandigarh 160012, India. Electronic address: mrshivprakash@yahoo.com. 5. Centre of Advanced Research in Medical Mycology, WHO Collaborating Centre for Reference & Research on Fungi of Medical Importance, National Culture Collection of Pathogenic Fungi, Head, Department of Medical Microbiology, Postgraduate Institute of Medical Education & Research, Chandigarh 160012, India.
Abstract
PURPOSE: To determine the prevalence of Candida auris candidaemia in our ICU patients and its molecular epidemiology. METHODS: A prospective observational study was conducted on candidaemia in our ICU patients over 18 months during 2016-2017. Demographics, underlying disease, risk factors, antifungal therapy and outcome were studied. Risk factors of C. auris and non-auris candidaemia were compared. RESULTS: During the study period, among 108 candidaemia cases recorded, the incidence was 6.75/1000 ICU bed days. C. auris topped the list (n = 42, 39.9%), followed by C. tropicalis (34.3%), and C. parapsilosis (15.7%). On bivariate analysis prior antibiotic therapy, long central line days, mechanical ventilation and length of ICU stay were significant risk factors for C. auris candidaemia compared to non-auris candidaemia. Multivariate analysis showed underlying respiratory and neurological diseases as significantly associated with risk of C. auris candidaemia. Fluconazole, amphotericin B, and caspofungin resistance were noted in 97.0%, 93.7% and 3% of C. auris isolates respectively. CONCLUSION: Longer duration of central line days, prior antibiotic use, mechanical ventilation and prolonged ICU stay were important risk factors associated with C. auris candidaemia along with underlying respiratory or neurological disease. The isolates are non-clonal in origin, but they belong to a single clade.
PURPOSE: To determine the prevalence of Candida auris candidaemia in our ICU patients and its molecular epidemiology. METHODS: A prospective observational study was conducted on candidaemia in our ICU patients over 18 months during 2016-2017. Demographics, underlying disease, risk factors, antifungal therapy and outcome were studied. Risk factors of C. auris and non-auris candidaemia were compared. RESULTS: During the study period, among 108 candidaemia cases recorded, the incidence was 6.75/1000 ICU bed days. C. auris topped the list (n = 42, 39.9%), followed by C. tropicalis (34.3%), and C. parapsilosis (15.7%). On bivariate analysis prior antibiotic therapy, long central line days, mechanical ventilation and length of ICU stay were significant risk factors for C. auris candidaemia compared to non-auris candidaemia. Multivariate analysis showed underlying respiratory and neurological diseases as significantly associated with risk of C. auris candidaemia. Fluconazole, amphotericin B, and caspofungin resistance were noted in 97.0%, 93.7% and 3% of C. auris isolates respectively. CONCLUSION: Longer duration of central line days, prior antibiotic use, mechanical ventilation and prolonged ICU stay were important risk factors associated with C. auris candidaemia along with underlying respiratory or neurological disease. The isolates are non-clonal in origin, but they belong to a single clade.
Authors: Jeffrey M Rybak; Katherine S Barker; José F Muñoz; Josie E Parker; Suhail Ahmad; Eiman Mokaddas; Aneesa Abdullah; Rehab S Elhagracy; Steve L Kelly; Christina A Cuomo; P David Rogers Journal: Clin Microbiol Infect Date: 2021-12-13 Impact factor: 13.310
Authors: Mahmoud Ghannoum; Maiken Cavling Arendrup; Vishnu P Chaturvedi; Shawn R Lockhart; Thomas S McCormick; Sudha Chaturvedi; Elizabeth L Berkow; Deven Juneja; Bansidhar Tarai; Nkechi Azie; David Angulo; Thomas J Walsh Journal: Antibiotics (Basel) Date: 2020-08-25
Authors: João Nobrega de Almeida; Igor B Brandão; Elaine C Francisco; Silvio Luis R de Almeida; Patrícia de Oliveira Dias; Felicidade M Pereira; Fábio Santos Ferreira; Thaisse Souza de Andrade; Magda M de Miranda Costa; Regiane T de Souza Jordão; Jacques F Meis; Arnaldo L Colombo Journal: Mycoses Date: 2021-06-07 Impact factor: 4.931
Authors: Instructor Sarah E Turbett; Doctoral Student Margaret Becker; Medical Technologist Barbara Belford; Research Technologist Meagan Kelly; Medical Technologist Lisa Desrosiers; Research Nurse Elizabeth Oliver; Associate Professor John A Branda; Epidemiologist Maroya Walters; Epidemiologist Allison Taylor Walker; Associate Professor Regina LaRocque; Professor Edward T Ryan Journal: J Travel Med Date: 2022-01-17 Impact factor: 8.490