| Popis: |
Background Candida auris is a multidrug resistant yeast that was originally isolated in the external ear of a patient in Japan in 2009. Since then, it has rapidly spread throughout the world. C. auris is inherently a multidrug resistant organism, making echinocandins the drugs of choice. C. auris was first isolated in SBH in a wound culture in 2018, and it has become a major health concern. Our objectives were to evaluate our clinical C. auris isolates, identify potential risk factors for infection, and assess our susceptibilities to determine the most appropriate treatment option. Methods This was a retrospective chart review of all clinical isolates of C. auris from July 2018 – April 2021. Data collection included location prior to admission, SBH hospitalization within 90 days, hospital vs community acquired, new vs recurrent, specimen type, susceptibilities, and lines at the time of culture. Results A total of 121 clinical isolates were evaluated from 74 patients. Although initially clinical isolates were rare, prevalence increased in subsequent years, with 97 clinical isolates identified in 2020. Isolates were identified in various specimen types, with the majority in urine, respiratory samples, or blood cultures. 64% of the isolates were hospital onset. Among patients who tested positive for C. auris colonization through surveillance testing, 22% proceeded to develop clinical infections. Most of the patients with positive blood cultures had either one or multiple IV access points, which may be a risk factor for candidemia. All isolates were resistant to fluconazole, 87% were susceptible to amphotericin B, and susceptibility to echinocandins ranged from 98-99%. Susceptibilities Susceptibilities for the Candida auris clinical isolates received from the NYS Department of Health Specimen Type IV Access in Positive Blood Cultures Access points that were present at the time of candidemia Conclusion Candida auris is a persistent fungus that is highly contagious that has been increasing in prevalence. Infection control measures remain the most proven method to decrease the development of clinical infections. Our study has some limitations, such as the retrospective design, the lack of a control group, lack of clinical outcomes, and limited surveillance testing capabilities. C. auris remains a major cause of concern for nosocomial infections, particularly in patients with various indwelling catheters. Our susceptibilities confirmed echinocandins as the class of choice for treatment of C. auris infections. Disclosures Judith Berger, MD, Nothing to disclose |
