Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025
Geographical variation in the clinical profile of patients with Candida auris.
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Schieber Taylor, Roemer Kaleb, Sands Kenneth, Greer Nickie, Moody Julia, Watson Troy, Hasse Adam
Аннотация
OBJECTIVE: To describe Candida auris infections from two different geographical regions within a large health-system, both of which have experienced a significant increase in the occurrence of C. auris.
DESIGN: Multicenter, retrospective, descriptive analysis across a large healthcare system.
METHODS: Patients were included in this study if they were admitted as an inpatient between January 1, 2021 and September 30, 2022 and had a clinical specimen that grew C. auris.
RESULTS: A total of 321 patients were included. The clinical outcomes of included patients were comparable between geographical regions (Western and Eastern), with the exception of patients who experienced mortality or transitioned to hospice care at discharge (Western 32.1% vs Eastern 19.1%, P = .014). Over one-third of patients required mechanical ventilation at any point during their admission, while greater than half of the total study population had receipt of a blood transfusion. Approximately 25.2% of all patients received hemodialysis, while 24.3% received total parental nutrition during their hospital stay. More than 50% of patients in both regions required an admission to the intensive care unit at any time-frame during their stay. Fluconazole-resistant isolates were more prevalent in the Western region, but both regions demonstrated a high prevalence of resistance.
CONCLUSION: Patients identified with C. auris were characterized by significant underlying morbidity and disease burden. Further studies are warranted to identify infection prevention best practices to reduce transmission and reduce mortality through earlier identification and appropriate antifungal therapy.
DESIGN: Multicenter, retrospective, descriptive analysis across a large healthcare system.
METHODS: Patients were included in this study if they were admitted as an inpatient between January 1, 2021 and September 30, 2022 and had a clinical specimen that grew C. auris.
RESULTS: A total of 321 patients were included. The clinical outcomes of included patients were comparable between geographical regions (Western and Eastern), with the exception of patients who experienced mortality or transitioned to hospice care at discharge (Western 32.1% vs Eastern 19.1%, P = .014). Over one-third of patients required mechanical ventilation at any point during their admission, while greater than half of the total study population had receipt of a blood transfusion. Approximately 25.2% of all patients received hemodialysis, while 24.3% received total parental nutrition during their hospital stay. More than 50% of patients in both regions required an admission to the intensive care unit at any time-frame during their stay. Fluconazole-resistant isolates were more prevalent in the Western region, but both regions demonstrated a high prevalence of resistance.
CONCLUSION: Patients identified with C. auris were characterized by significant underlying morbidity and disease burden. Further studies are warranted to identify infection prevention best practices to reduce transmission and reduce mortality through earlier identification and appropriate antifungal therapy.