Abstract

Candida auris is a globally emerging multi-drug resistant yeast, causing bloodstream, wound, urinary and respiratory tract infections. Understanding the epidemiology and risk factors associated with C. auris infection, would help in early diagnosis and instituting appropriate antifungal therapy. In this retrospective observational study, we analyzed the clinical and epidemiological data of twelve cases of C. auris from our institute for a period of 3 years from 2018 to 2020. The demographic, clinical and microbiological data were collected and analyzed. Identification was done by Vitek 2C and antifungal susceptibility testing by broth microdilution for all the isolates. Of the total 217 patients diagnosed with invasive candidiasis, C. auris was the causative species in 12 (5.5%) patients. C.auris was isolated from blood in 10/12 (83.3%) of these patients and from pus and tissue in one patient each with surgical site infection (SSI). Risk factors identified were the presence of invasive devices, surgical procedures, neutropenia, prolonged ICU stay, previous hospitalization, previous bacterial and fungal infections, prior use of broad-spectrum antimicrobials and antifungals. High MIC to amphotericin B (MIC range 8-16µg/ml) and fluconazole (MIC range 32-64µg/ml) were noted in 11 of 12 isolates. Seven patients with sepsis expired before C.auris infection was reported. In the present study, the isolates of C.auris were multidrug resistant which is a matter of concern. Presence of risk factors that might have led to the nosocomial acquisition of C.auris infection.

Key words: Antifungal resistance, Intensive care unit, Invasive devices