1. Case-Case Comparison of Candida auris Versus Other Candida Species Bloodstream Infections: Results of an Outbreak Investigation in Colombia.
- Author
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Caceres DH, Rivera SM, Armstrong PA, Escandon P, Chow NA, Ovalle MV, Díaz J, Derado G, Salcedo S, Berrio I, Espinosa-Bode A, Varón C, Stuckey MJ, Mariño A, Villalobos N, Lockhart SR, Chiller TM, Prieto FE, and Jackson BR
- Subjects
- Adult, Antifungal Agents therapeutic use, Candidemia diagnosis, Candidemia drug therapy, Candidiasis drug therapy, Candidiasis epidemiology, Colombia epidemiology, Cross Infection diagnosis, Cross Infection epidemiology, Diabetes Complications microbiology, Disease Outbreaks, Female, Humans, Infection Control, Intensive Care Units, Male, Middle Aged, Retrospective Studies, Risk Factors, Sepsis complications, Sepsis microbiology, Treatment Outcome, Young Adult, Candida isolation & purification, Candidemia epidemiology, Candidiasis diagnosis, Diagnosis, Differential
- Abstract
Background: Candida auris is an emerging multidrug-resistant yeast that causes outbreaks in healthcare settings around the world. In 2016, clinicians and public health officials identified patients with C. auris bloodstream infections (BSI) in Colombian healthcare facilities. To evaluate potential risk factors and outcomes for these infections, we investigated epidemiologic and clinical features of patients with C. auris and other Candida species BSI., Methods: We performed a retrospective case-case investigation in four Colombian acute care hospitals, defining a case as Candida spp. isolated from blood culture during January 2015-September 2016. C. auris BSI cases were compared to other Candida species BSI cases. Odds ratio (OR), estimated using logistic regression, was used to assess the association between risk factors and outcomes., Results: We analyzed 90 patients with BSI, including 40 with C. auris and 50 with other Candida species. All had been admitted to the intensive care unit (ICU). No significant demographic differences existed between the two groups. The following variables were independently associated with C. auris BSI: ≥ 15 days of pre-infection ICU stay (OR: 5.62, CI: 2.04-15.5), evidence of severe sepsis (OR: 3.70, CI 1.19-11.48), and diabetes mellitus (OR 5.69, CI 1.01-31.9)., Conclusion: Patients with C. auris BSI had longer lengths of ICU stay than those with other candidemias, suggesting that infections are acquired during hospitalization. This is different from other Candida infections, which are usually thought to result from autoinfection with host flora.
- Published
- 2020
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