Emerging infectious diseases · 2019
Epidemiologic Shift in Candidemia Driven by Candida auris, South Africa, 2016-20171.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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van Schalkwyk Erika, Mpembe Ruth S, Thomas Juno, Shuping Liliwe, Ismail Husna, Lowman Warren, Karstaedt Alan S, Chibabhai Vindana, Wadula Jeannette, Avenant Theunis, Messina Angeliki, Govind Chetna N, Moodley Krishnee, Dawood Halima, Ramjathan Praksha, Govender Nelesh P, GERMS-SA
Аннотация
Candida auris is an invasive healthcare-associated fungal pathogen. Cases of candidemia, defined as illness in patients with Candida cultured from blood, were detected through national laboratory-based surveillance in South Africa during 2016-2017. We identified viable isolates by using mass spectrometry and sequencing. Among 6,669 cases (5,876 with species identification) from 269 hospitals, 794 (14%) were caused by C. auris. The incidence risk for all candidemia at 133 hospitals was 83.8 (95% CI 81.2-86.4) cases/100,000 admissions. Prior systemic antifungal drug therapy was associated with a 40% increased adjusted odds of C. auris fungemia compared with bloodstream infection caused by other Candida species (adjusted odds ratio 1.4 [95% CI 0.8-2.3]). The crude in-hospital case-fatality ratio did not differ between Candida species and was 45% for C. auris candidemia, compared with 43% for non-C. auris candidemia. C. auris has caused a major epidemiologic shift in candidemia in South Africa.