Candida auris candidaemia in Indian ICUs: analysis of risk factors

Rudramurthy, Shivaprakash M.; Chakrabarti, Arunaloke; Paul, Raees A.; Sood, Prashant; Kaur, Harsimran; Capoor, Malini R.; Kindo, Anupma Jyoti; Marak, Rungmei S. K.; Arora, Anita; Sardana, Raman; Das, Shukla; Chhina, Deepinder; Patel, Atul; Xess, Immaculata; Tarai, Bansidhar; Singh, Meenu; Ghosh, Anup

doi:10.1093/jac/dkx034

Cited by 245 publications

(248 citation statements)

References 21 publications

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“…Notably, in a short span of 5 years, C. auris has emerged as a significant cause of nosocomial infections in Asia, South Africa, Latin America, the United States, United Kingdom, and more recently in Spain and Israel (1)(2)(3)(4)(5)(6)(7)(8)(9). Moreover, isolated cases have been reported in Germany and Norway (10).…”

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confidence: 99%

Comparison of EUCAST and CLSI Reference Microdilution MICs of Eight Antifungal Compounds for Candida auris and Associated Tentative Epidemiological Cutoff Values

Arendrup

Prakash

Meletiadis

et al. 2017

Antimicrob Agents Chemother

199

186

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Candida auris is an emerging multidrug-resistant yeast. So far, all but two susceptibility testing studies have examined Յ50 isolates, mostly with the CLSI method. We investigated CLSI and EUCAST MICs for 123 C. auris isolates and eight antifungals and evaluated various methods for epidemiological cutoff (ECOFF) determinations. MICs (in milligrams per liter) were determined using CLSI method M27-A3, and the EUCAST E.Def 7.3. ANOVA analysis of variance with Bonferroni's multiple-comparison test and Pearson analysis were used on log 2 MICs (significance at P values of Ͻ0.05). The percent agreement (within Ϯ0 to Ϯ2 2-fold dilutions) between the methods was calculated. ECOFFs were determined visually, statistically (using the ECOFF Finder program and MicDat1.23 software with 95% to 99% endpoints), and via the derivatization method (dECOFFs). The CLSI and EUCAST MIC distributions were wide, with several peaks for all compounds except amphotericin B, suggesting possible acquired resistance. Modal MIC, geometric MIC, MIC 50 , and MIC 90 values were Յ1 2-fold dilutions apart, and no significant differences were found. The quantitative agreement was best for amphotericin B (80%/97% within Ϯ1/Ϯ2 dilutions) and lowest for isavuconazole and anidulafungin (58%/76% to 75% within Ϯ1/Ϯ2 dilutions). We found that 90.2%/100% of the isolates were amphotericin B susceptible based on CLSI/EUCAST methods, respectively (i.e., with MICs of Յ1 mg/liter), and 100%/ 97.6% were fluconazole nonsusceptible by CLSI/EUCAST (MICs Ͼ 2). The ECOFFs (in milligrams per liter) were similar across the three different methods for itraconazole (ranges for CLSI/EUCAST, 0.25 to 0.5/0.5 to 1), posaconazole (0.125/0.125 to 0.25), amphotericin B (0.25 to 0.5/1 to 2), micafungin (0.25 to 0.5), and anidulafungin (0.25 to 0.5/0.25 to 1). In contrast, the estimated ECOFFs were dependent on the method applied for voriconazole (1 to 32) and isavuconazole (0.125 to 4). CLSI and EUCAST MICs were remarkably similar and confirmed uniform fluconazole resistance and variable acquired resistance to the other agents.

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mentioning

confidence: 99%

Comparison of EUCAST and CLSI Reference Microdilution MICs of Eight Antifungal Compounds for Candida auris and Associated Tentative Epidemiological Cutoff Values

Arendrup

Prakash

Meletiadis

et al. 2017

Antimicrob Agents Chemother

199

186

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“…The source of C. auris is not yet known, but one source could have been related to the hospitalization in India where C. auris is known to be endemic (6,17). Due to the chronicity of ear symptoms and the prior (unconfirmed) clinical diagnosis of otomycosis, the infection may have preceded the patient's most recent travel; however, the patient had been in India prior to the onset of the ear symptoms as well.…”

Section: Resultsmentioning

confidence: 99%

“…In developing countries, the risk of C. auris transmission is compounded by limitations in capacity for fungal identification, antifungal susceptibility testing and infection prevention and control (IPC). In India, for instance, C. auris already accounts for 5% of the isolates implicated in candidemia in intensive care units nationwide (6) and as many as 30% in some centres (7).…”

Section: Discussionmentioning

confidence: 99%

First reported case of multidrug-resistant Candida auris in Canada

Schwartz

Hammond

2017

Canada Communicable Disease Report

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“…In 27 ICUs 1400 cases of Candida infection were reported, among which 74 (5.3%) were isolated and confirmed as C. auris. In patients with diagnosis of candidemia, those infected with C. auris had an average period of hospital stay of 25 days, which was higher than those infected with non-auris Candida, with a mean of 15 days 22 . In the city of New Delhi, in two hospitals, 12 C. auris were isolated, collected between 2009 and 2011.…”

Section: Epidemiologymentioning

confidence: 95%

Candida Auris: Emergence and Epidemiology of a Highly Pathogenic Yeast

Santos¹,

Lana²,

Mezzari³

2017

Clin. Biomed. Res.

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Candida auris is a multidrug-resistant emerging yeast, which was responsible for healthcare-associated infection outbreaks, and was cataloged as a new species in 2009, after being isolated from a patient's ear canal secretion in Japan. Since the notification of this first occurrence, numerous cases have been reported throughout the world, including Brazil. C. auris affects mainly inpatients, patients in intensive care units, exposed to broad-spectrum antifungal medications and who make use of vascular catheters. Currently, this yeast is one of the main responsible for invasive infections in hospitals and has been cause of concern by authorities and organs due to its rapid dissemination and difficult treatment caused by its low susceptibility to antifungal agents traditionally used in clinical practice. As a contributor to the severity of infections associated with C. auris, the transmission mechanism is still unknown, which implies in a lack of control of the microorganism and high mortality rates. Thus, this literature review presents relevant information in order to alert the importance of C. auris as an etiological agent of systemic infections, as well as its epidemiology and the real challenges of the treatment.

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Candida auris candidaemia in Indian ICUs: analysis of risk factors

Cited by 245 publications

References 21 publications

Comparison of EUCAST and CLSI Reference Microdilution MICs of Eight Antifungal Compounds for Candida auris and Associated Tentative Epidemiological Cutoff Values

Comparison of EUCAST and CLSI Reference Microdilution MICs of Eight Antifungal Compounds for Candida auris and Associated Tentative Epidemiological Cutoff Values

First reported case of multidrug-resistant Candida auris in Canada

Candida Auris: Emergence and Epidemiology of a Highly Pathogenic Yeast

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