Epidemiology, Risk Factors, Clinical features and Outcome of Candida auris in Royal Hospital over the Last Four Years (2017-2020)

ABSTRACT

Objectives: Candida auris is a new strain of fungal pathogen that had emerged in many countries worldwide, including Oman. Te invasive infections were linked to high mortality, one of the reasons being multidrug-resistant to major classes of antifungals. Te ability to spread from patient to patient, or from contaminated environment to patients within health care settings and tendency to cause major outbreaks. Te study mainly aims to describe the trend of Candida auris emergence and distributions during the last four years and its outcome. Moreover, we identify the risk factors associated with Candida auris infection or colonization to assess the incidence, susceptibility, and resistance pattern as well as asses the implementations and efectiveness of the infection prevention and control measures applied to control the outbreak. Method(s) A retrospective descriptive cohort was conducted in Royal hospital. Target population are adult patients admitted to Royal hospital from 2017 to 2020, looking for patients positive with Candida auris from any sample (screening and clinical) during the study period were defned as infections or colonization cases. Result(s) Overall incidence increasing in trend since 2017, which is contributed to many reasons including implementation of active surveillance and COVID pandemic. Diabetes milletus and recent admission in another hospital within 6 months were considered statistically significant risk factors in relation to the infection. Mortality rate was 40.0%. Median of length of hospital stay = 31 (1-380). Statistically Significant risk factors in relation to mortality were chronic kidney disease, intubation, infection, and age. Conclusion(s) Early notifcation of the cases is vital for early implementation of infection control preventive measures. Active surveillance at Royal Hospital was refected efectively in controlling the outbreak at the intensive unit care in few months. Current data on the signifcant risk factors will be utilized later to set a criteria for screening high risk patients for colonization.