Clinical and laboratory features of patients with Candida auris cultures, compared to other Candida, at a South African Hospital
Keywords:Candida auris, candidemia, drug resistant Candida
Introduction: Multidrug resistant Candida auris is an emerging threat worldwide. It has been identified in Africa, however, there is minimal data available comparing C. auris to other Candida species in Africa.
Methodology: Retrospective, case control study at a tertiary South African Hospital. Clinical and laboratory features of patients with positive C. auris clinical cultures from 1 January 2015 to 31 August 2018 were compared to patients who cultured C. albicans and C. glabrata.
Results: Forty-five clinical cases with C. auris cultures were identified. The median age was 32 years (IQR = 26-46). The median duration of hospital stay was 64 days (IQR = 39-88) and median time from admission to diagnosis 35 days (IQR = 21-53). Indwelling devices and previous antibiotic exposure were found to be significant risk factors. All C. auris isolates were susceptible to amphotericin B and micafungin. Patients treated with amphotericin B alone, had a higher mortality (73.33%, n = 11/15) than patients treated with an echinocandin (54.55%, n = 6/11), however this was not statistically significant. All C. auris isolates were healthcare associated with 80% (n = 36/45) acquired in ICU. The 30-day all-cause in-patient mortality was 42% (n = 19/45) for C. auris, 36% (n = 16/45) for C. albicans and 53% (n = 24/45) for C. glabrata.
Conclusions: C. auris is an emerging multi drug resistant threat in South Africa. Improved access to echinocandins and improvement of infection prevention and control strategies are imperative to prevent further morbidity and mortality due to this pathogen.
How to Cite
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).