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Published on: December 28, 2017
A multicentric outbreak of Candida auris in Mexico: 2020 to 2023
Patricia Rodríguez-de la Garza1, Carlos de la Cruz-de la Cruz1, José Iván Castillo Bejarano2
1Department of Internal Medicine; Christus Muguerza Hospital Alta Especialidad, Universidad de Monterrey, Monterrey, Mexico.
Background:
Candida auris, an emerging multidrug-resistant yeast, has become a global concern due to its association with nosocomial outbreaks and resistance to antifungal medications. The COVID-19 pandemic has exacerbated the situation, with several outbreaks reported worldwide, including in Mexico. We describe the clinical and microbiological characteristics of a multicentric outbreak in private institutions in Mexico.
Methods:
A retrospective observational study was conducted across 4 Christus Muguerza Hospital Health Care System facilities in Monterrey, Mexico, where simultaneous outbreaks of C auris occurred. Patients with colonization or infection with C auris between September 2020 and December 2023 were included.
Results:
Analysis revealed 37 cases, predominantly male (median age, 55.8years). While most cases were initially colonization, a significant proportion progressed to infection (32.4%). Patients with documented infection had longer intensive care unit and hospital stays, often requiring mechanical ventilation. Antifungal treatment varied, with empirical fluconazole being the first drug in most cases, followed by anidulafungin and caspofungin. Resistance to fluconazole was widespread, but susceptibility to other antifungals varied. The overall mortality rates were high (40.5%), with no significant difference in median survival between colonized and infected patients.
Conclusions:
We reported a high rate of infection in previously colonized cases associated with longer hospital lenght stay, and a high susceptibility to echinocandins.
Insights
A multicentric outbreak of Candida auris in Mexico affected 37 patients, with many progressing from colonization to infection. High mortality was observed, but echinocandins showed promising susceptibility.
Area of Science:
- * Infectious Diseases
- * Clinical Microbiology
- * Epidemiology
Background:
- * Candida auris is a multidrug-resistant yeast causing global health concerns and nosocomial outbreaks.
- * The COVID-19 pandemic has coincided with an increase in Candida auris outbreaks worldwide.
- * This study details a multicentric outbreak in private healthcare facilities in Mexico.
Purpose of the Study:
- * To describe the clinical and microbiological features of a simultaneous Candida auris outbreak.
- * To analyze patient outcomes and antifungal susceptibility during the outbreak.
Main Methods:
- * Retrospective observational study across four hospital facilities.
- * Inclusion of patients with Candida auris colonization or infection from September 2020 to December 2023.
- * Data collection on demographics, clinical presentation, treatment, and outcomes.
Main Results:
- * 37 cases identified, predominantly in males (median age 55.8 years).
- * 32.4% of cases progressed from colonization to infection, associated with longer ICU/hospital stays and mechanical ventilation.
- * High mortality (40.5%); fluconazole resistance was common, but echinocandins (anidulafungin, caspofungin) showed varied susceptibility.
Conclusions:
- * A significant rate of infection occurred in previously colonized patients.
- * Longer hospital stays were associated with infection progression.
- * High susceptibility to echinocandins was noted, offering a potential treatment avenue.
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