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Candida auris Candidemia in Critically Ill, Colonized Patients: Cumulative Incidence and Risk Factors.
Briano, Federica; Magnasco, Laura; Sepulcri, Chiara; Dettori, Silvia; Dentone, Chiara; Mikulska, Malgorzata; Ball, Lorenzo; Vena, Antonio; Robba, Chiara; Patroniti, Nicolò; Brunetti, Iole; Gratarola, Angelo; D'Angelo, Raffaele; Di Pilato, Vincenzo; Coppo, Erika; Marchese, Anna; Pelosi, Paolo; Giacobbe, Daniele Roberto; Bassetti, Matteo.
  • Briano F; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
  • Magnasco L; Infectious Diseases Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, L.go R. Benzi 10, 16132, Genoa, Italy.
  • Sepulcri C; Infectious Diseases Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, L.go R. Benzi 10, 16132, Genoa, Italy.
  • Dettori S; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
  • Dentone C; Infectious Diseases Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, L.go R. Benzi 10, 16132, Genoa, Italy.
  • Mikulska M; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
  • Ball L; Infectious Diseases Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, L.go R. Benzi 10, 16132, Genoa, Italy.
  • Vena A; Infectious Diseases Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, L.go R. Benzi 10, 16132, Genoa, Italy.
  • Robba C; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
  • Patroniti N; Infectious Diseases Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, L.go R. Benzi 10, 16132, Genoa, Italy.
  • Brunetti I; Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy.
  • Gratarola A; Anesthesia and Intensive Care, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy.
  • D'Angelo R; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
  • Di Pilato V; Infectious Diseases Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, L.go R. Benzi 10, 16132, Genoa, Italy.
  • Coppo E; Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy.
  • Marchese A; Anesthesia and Intensive Care, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy.
  • Pelosi P; Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy.
  • Giacobbe DR; Anesthesia and Intensive Care, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy.
  • Bassetti M; Anesthesia and Intensive Care, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy.
Infect Dis Ther ; 11(3): 1149-1160, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1783017
ABSTRACT

INTRODUCTION:

Candida auris (C. auris) is an emerging nosocomial pathogen, and a sharp rise in cases of colonization and infection has been registered in intensive care units (ICUs) during the ongoing coronavirus disease 2019 (COVID-19) pandemic. The unfavorable resistance profile of C. auris and the potential high mortality of C. auris infections represent an important challenge for physicians.

METHODS:

We conducted a single-center retrospective study including all patients admitted to ICUs with isolation of C. auris in any non-sterile body site between February 20, 2020, and May 31, 2021. The primary aim of the study was to assess the cumulative incidence of C. auris candidemia in colonized patients. The secondary aim was to identify predictors of C. auris candidemia in the study population.

RESULTS:

During the study period, 157 patients admitted to ICUs in our hospital became colonized with C. auris; 59% of them were affected by COVID-19. Overall, 27 patients (17%) developed C. auris candidemia. The cumulative risk of developing C. auris candidemia was > 25% at 60 days after first detection of C. auris colonization. Seven patients with C. auris candidemia (26%) also developed a late recurrent episode. All C. auris blood isolates during the first occurring episode were resistant to fluconazole and susceptible to echinocandins, while 15 (56%) were resistant to amphotericin B. During late recurrent episodes, emergent resistance to caspofungin and amphotericin B occurred in one case each. In the final multivariable model, only multisite colonization retained an independent association with the development of C. auris candidemia.

CONCLUSION:

Candida auris candidemia may occur in up to one fourth of colonized critically ill patients, and multisite colonization is an independent risk factor for the development of candidemia. Implementing adequate infection control measures remains crucial to prevent colonization with C. auris and indirectly the subsequent development of infection.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study Language: English Journal: Infect Dis Ther Year: 2022 Document Type: Article Affiliation country: S40121-022-00625-9

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study Language: English Journal: Infect Dis Ther Year: 2022 Document Type: Article Affiliation country: S40121-022-00625-9