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Candida auris Candidemia in Critically Ill, Colonized Patients: Cumulative Incidence and Risk Factors
Federica Briano1,2, Laura Magnasco2, Chiara Sepulcri1,2
1Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
Multisite colonization with Candida auris (C. auris) significantly increases the risk of candidemia in critically ill patients. Effective infection control is vital to prevent C. auris spread and subsequent invasive infections.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Mycology
Background:
- Candida auris (C. auris) is an emerging nosocomial pathogen causing infections in intensive care units (ICUs).
- The COVID-19 pandemic has seen a rise in C. auris colonization and infection.
- C. auris presents challenges due to its resistance profile and high mortality.
Purpose of the Study:
- To assess the cumulative incidence of C. auris candidemia in colonized ICU patients.
- To identify predictors of C. auris candidemia development.
- To analyze antifungal resistance patterns in C. auris isolates.
Main Methods:
- Single-center retrospective study of ICU patients with C. auris isolation.
- Inclusion period: February 20, 2020, to May 31, 2021.
- Analysis of cumulative incidence, predictors, and antifungal susceptibility.
Main Results:
- 157 patients were colonized with C. auris; 59% had COVID-19.
- 27 patients (17%) developed C. auris candidemia, with a cumulative risk >25% at 60 days.
- Multisite colonization was the sole independent predictor of candidemia.
- High resistance rates to fluconazole and amphotericin B observed; echinocandins showed susceptibility initially.
Conclusions:
- C. auris candidemia can affect up to 25% of colonized critically ill patients.
- Multisite colonization is a significant independent risk factor for candidemia.
- Robust infection control measures are essential to prevent C. auris colonization and subsequent infections.
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