South Asian (Clade I) Candida auris meningitis in a paediatric patient in Iran with a review of the literature

Abstract

Bloodstream and disseminated infections due to Candida species are the most common life-threatening yeast infections among patients with profound and prolonged immunosuppression. 1 The majority of cases are healthcare associated, and common risk factors are the presence of central venous catheters, mechanical ventilation, gastrointestinal surgery, severe malignancies, haemodialysis, diabetes,

In Vivo Efficacy of Amphotericin B against Four Candida auris Clades

“…Although CNS involvement is rare, cases of ventriculitis have been observed among adult patients with neurosurgical interventions or subarachnoid hemorrhages [ 32 , 33 ]. Moreover, an Iranian infant developed meningitis due to a C. auris isolate belonging to the South Asian clade [ 34 ].…”

“…Thus, repeated blood and urine culture may help to differentiate between contamination and candiduria with or without bloodstream infection. Persistent or recurrent candidemia due to the weak killing activity of antifungals increases the risk for heart, eye or CNS infection leading to further complications [ 8 , 9 , 10 , 11 , 30 , 31 , 32 , 33 , 34 , 39 ]. As AMB is still the first therapeutic choice in certain clinical situations (i.e., neonates and infants < 2 months of age, meningitis, endophthalmitis and urinary tract infections), physicians should be aware of inadequate fungal killing with normal doses of AMB or even echinocandins [ 2 ].…”

“…Higher daily doses with echinocandins or lipid-associated AMB may prevent these complications during candidemia (i.e., meningitis, endophthalmitis and endo/myocarditis). Moreover, combinations of AMB with echinocandins frequently led to complete eradication of C. auris , even from the CNS [ 10 , 32 , 33 , 34 ]. However, AMB treatment is limited by infusion-related acute toxicity (i.e., chest pain, fever and hypoxia) and dose-dependent nephrotoxicity (i.e., renal insufficiency, azotemia and hypokalemia) [ 15 ].…”

Multiplex size marker (YEAST PLEX) for rapid and accurate identification of pathogenic yeasts

“…auris can cause hospital outbreaks, the management of which could be difficult because of environmental persistence and the antifungal resistance of C . auris 6‐8 . Moreover, other non‐ Candida yeasts, including members of the genera Cryptococcus , Trichosporon , Rhodotorula , and Saccharomyces , have also been reported to cause life‐threatening infections and to be resistant to antifungal drugs 9,10 …”

“…auris . 6 , 7 , 8 Moreover, other non‐ Candida yeasts, including members of the genera Cryptococcus , Trichosporon , Rhodotorula , and Saccharomyces , have also been reported to cause life‐threatening infections and to be resistant to antifungal drugs. 9 , 10 …”