Five‐year profile of candidaemia at an Indian trauma centre: High rates of Candida auris blood stream infections

Abstract

Candidaemia is a potentially fatal infection with varied distribution of Candida species and their antifungal susceptibility profiles. The recent emergence of Candida auris in invasive candidiasis is a cause for concern. This study describes the profile of candidaemia at an Indian tertiary care hospital and reports the emergence of C. auris. All patients diagnosed with candidaemia between 2012 and 2017 were studied. The isolates were identified using conventional methods, VITEK 2 and MALDI-TOF MS. The isolates not identified by MALDI-TOF were sequenced. Antifungal susceptibility testing was done by the CLSI broth microdilution method and VITEK 2. A total of 114 isolates of Candida species were analysed. Candida tropicalis (39.4%) was the most common species, followed by C. auris (17.5%), C. albicans (14%) and C. parapsilosis (11.4%). Notably, Diutina mesorugosa isolates (n = 10) were not identified by MALDI-TOF and were confirmed by sequencing. Furthermore, 45% (n = 9) C. auris strains exhibited low MICs of FLU (0.05-4 μg/mL) and the remaining 55% (n = 11) isolates had high MICs ≥ 64 μg/mL. Also, D. mesorugosa exhibited high MICs of FLU (32 μg/mL) in 2 isolates. A high rate of errors in antifungal susceptibility was noted with the VITEK 2 as compared to the CLSI method. Candida auris was the second most prevalent species causing candidaemia warranting infection control practices to be strengthened to prevent its spread.

Evaluation of a new T2 Magnetic Resonance assay for rapid detection of emergent fungal pathogen Candida auris on clinical skin swab samples

“…Emphasising this point, the largest C. auris outbreak to date was recently documented in a European hospital . Furthermore, a 5 year study of candidemia in an Indian facility revealed C. auris was the second most prevalent blood culture isolate behind only C. tropicalis . Genetic and epidemiological studies have shown that health care associated transmission is driving the ongoing spread of C. auris .…”

Internal validation of GPS™MONODOSE CanAur dtec‐qPCR kit following the UNE/EN ISO/IEC 17025:2005 for detection of the emerging yeast Candida auris

“…Several worldwide outbreaks have been reported since its description in 2009, however, C. auris still may be misidentified by commercial identification strategies because this species is phylogenetically closely related to the C. haemulonii complex ( Candida haemulonii, C. lusitaniae, C. pseudohaemulonii and C. duobushaemulonii ) . In some hospitals C. auris is the second most common isolated yeast from bloodcultures . The availability of a rapid and reliable detection method remains a challenge of primary importance for both, the antifungal therapy administration and the implementation of measures to control the spread of outbreaks by the public health institutions.…”

“…[9][10][11][12]35,36 In some hospitals C. auris is the second most common isolated yeast from bloodcultures. 38 The availability of a rapid and reliable detection method remains a challenge of primary importance for both, the antifungal therapy administration and the imple- ), therefore, the model was accepted. The efficiency or yield of the PCR amplification was found to be e = 97.95%, fitting well in the range of 90%-110%.…”

Candida auris: A Decade of Understanding of an Enigmatic Pathogenic Yeast

“…Since then, invasive infections, especially candidemia, have increased [8]. The emergence of C. auris has changed candidemia epidemiology in certain countries, even outcompeting the most common fungal pathogen Candida albicans at a number of centers in South Africa [9][10][11][12][13]. Additionally, outbreaks continuing for months have been described, sometimes resulting in the closing of intensive care units [10,14,15].…”