Five‐year profile of candidaemia at an Indian trauma centre: High rates of Candida auris blood stream infections. Issue 9 (5th July 2018)

• Record Type: Journal Article
• Authors: Mathur, Purva; Hasan, Fahmi; Singh, Pradeep K.; Malhotra, Rajesh; Walia, Kamini; Chowdhary, Anuradha
• Is Part Of: Mycoses. Volume 61:Issue 9(2018)
• Page Start: 674
• Page End: 680
• Publication Date: 2018-07-05
• Subjects: antifungal susceptibility testing -- Candida auris -- candidaemia -- India -- MALDI‐TOF MS -- VITEK 2; Pathogenic fungi -- Periodicals; Medical mycology -- Periodicals; 616.969
• DOI: 10.1111/myc.12790
• Languages: English
• ISSNs: 0933-7407

Abstract

Summary: Candidaemia is a potentially fatal infection with varied distribution of Candida species and their antifungal susceptibility profiles. The recent emergence of Candida auris in invasive candidiasis is a cause for concern. This study describes the profile of candidaemia at an Indian tertiary care hospital and reports the emergence of C. auris . All patients diagnosed with candidaemia between 2012 and 2017 were studied. The isolates were identified using conventional methods, VITEK 2 and MALDI‐TOF MS. The isolates not identified by MALDI‐TOF were sequenced. Antifungal susceptibility testing was done by the CLSI broth microdilution method and VITEK 2. A total of 114 isolates of Candida species were analysed. Candida tropicalis (39.4%) was the most common species, followed by C. auris (17.5%), C. albicans (14%) and C. parapsilosis (11.4%). Notably, Diutina mesorugosa isolates (n = 10) were not identified by MALDI‐TOF and were confirmed by sequencing. Furthermore, 45% (n = 9) C. auris strains exhibited low MICs of FLU (0.05‐4 μg/mL) and the remaining 55% (n = 11) isolates had high MICs ≥ 64 μg/mL. Also, D. mesorugosa exhibited high MICs of FLU (32 μg/mL) in 2 isolates. A high rate of errors in antifungal susceptibility was noted with the VITEK 2 as compared to the CLSI method. Candida auris was the second most prevalent species causing candidaemia warranting infection control practices to be strengthened to prevent its spread.