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Published on: August 16, 2021
Fungal Foe and Mechanical Hearts: A Retrospective Case Series on Candida auris Bloodstream Infection With Left
Ajay Kerai1, Saumil Doshi1, Ashley Laleker1
1Department of Internal Medicine and Department of Infectious Disease, MedStar Washington Hospital Center, Washington, District of Columbia, USA.
Abstract:
No guidelines currently exist for the management of Candida auris bloodstream infection in patients with left ventricular assist devices (LVADs). We aim to share our management experience through this retrospective case series outlining 15 episodes of C auris candidemia identified in 7 patients over 18 months. The initial source of candidemia was central venous catheter in 5 patients, driveline exit site infection in 1 patient, and possible pump infection in 1 patient. All patients were initially treated with micafungin. Despite susceptibility to micafungin, 4 patients experienced recurrent C auris candidemia. All patients died within 1 year of their first episode of C auris candidemia. Source control is challenging in patients with LVADs, and strict infection prevention measures should be practiced. More studies are needed to evaluate the role of newer antifungal agents, use of combination antifungal regimens, and impact on morbidity in patients with LVADs.
Insights
Management of Candida auris bloodstream infections in patients with left ventricular assist devices (LVADs) is challenging. This study found high mortality and recurrent infections despite initial treatment, highlighting the need for better strategies.
Area of Science:
- Infectious Diseases
- Cardiology
- Medical Device Management
Background:
- No established guidelines exist for managing Candida auris bloodstream infections (candidemia) in patients with left ventricular assist devices (LVADs).
- Candida auris is an emerging multidrug-resistant fungal pathogen posing significant clinical challenges.
- LVADs are crucial for heart failure management but can serve as potential sources for device-related infections.
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