Bloodstream infections with Candida auris among children in Colombia: Clinical characteristics and outcomes of 34 Cases
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Fecha
2020
Autores
Berrio, Indira
Caceres, Diego H.
Coronell R, Wilfrido
Salcedo, Soraya
Mora, Laura
Marin, Adriana
Varón, Carmen
Lockhart, Shawn R.
Escandón, Patricia
Berkow, Elizabeth L.
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Oxford University Press
Resumen
Background. Candida auris is an emerging multidrug-resistant yeast that can cause invasive infections and healthcareassociated
outbreaks. Here, we describe 34 cases of pediatric C. auris bloodstream infections (BSIs) identified during July 2014–
October 2017 in 2 hospitals in Colombia.
Methods. We conducted a retrospective review of microbiology records for possible C. auris cases in 2 hospitals in Barranquilla
and Cartagena. BSIs that occurred in patients aged <18 years confirmed as C. auris were included in this analysis.
Results. We identified 34 children with C. auris BSIs. Twenty-two (65%) patients were male, 21% were aged <28 days, 47% were
aged 29–365 days, and 32% were aged >1 year. Underlying conditions included preterm birth (26%), being malnourished (59%),
cancer (12%), solid-organ transplant (3%), and renal disease (3%). Eighty-two percent had a central venous catheter (CVC), 82%
were on respiratory support, 56% received total parenteral nutrition (TPN), 15% had a surgical procedure, and 9% received hemodialysis.
Preinfection inpatient stay was 22 days (interquartile range, 19–33 days), and in-hospital mortality was 41%.
Conclusions. Candida auris affects children with a variety of medical conditions including prematurity and malignancy, as well
as children with CVCs and those who receive TPN. Mortality was high, with nearly half of patients dying before discharge. However,
unlike most other Candida species, C. auris can be transmitted in healthcare settings, as suggested by the close clustering of cases in
time at each of the hospitals.
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Bloodstream infections, Candida auris, Children