Changing trends in the sources and volumes of clinical cultures with Candida auris at an integrated health system in Miami, Florida, United States, 2019-2023.

BACKGROUND

Candida auris (C auris) has rapidly spread in the United States. We aimed to characterize the trends in volumes and sources of clinical cultures with C auris at a large health care system.

METHODS

We conducted a retrospective observational study including clinical cultures with C auris collected between April 1, 2019, and December 31, 2023. Surveillance cultures were excluded. Clinical specimens were processed through routine methods, and identification was performed using mass spectrometry. Whole-genome sequencing was performed on select specimens.

RESULTS

We identified 327 clinical cultures belonging to 231 unique patients. The number of clinical cultures increased each year, from 5 in 2019 to 29 in 2020 (580%), 71 in 2021 (251% relative to 2020), 107 in 2022 (46% relative to 2021), and 115 in 2023 (7% relative to 2022). Blood cultures were the most common source, but specimens originating from soft tissue/bone infections had a large increase in 2022 and 2023. All sequenced isolates belong to clade III (South African clade) and were resistant to fluconazole and susceptible to echinocandins and amphotericin B.

CONCLUSIONS

The volumes of clinical cultures with C auris have rapidly increased, accompanied by an expansion in the sources of infection.