Background

Candida auris is an emerging multidrug-resistant yeast that causes outbreaks in healthcare settings around the world. In 2016, clinicians and public health officials identified patients with C. auris bloodstream infections (BSI) in Colombian healthcare facilities. To evaluate potential risk factors and outcomes for these infections, we investigated epidemiologic and clinical features of patients with C. auris and other Candida species BSI.

Methods

We performed a retrospective case-case investigation in four Colombian acute care hospitals, defining a case as Candida spp. isolated from blood culture during January 2015–September 2016. C. auris BSI cases were compared to other Candida species BSI cases. Odds ratio (OR), estimated using logistic regression, was used to assess the association between risk factors and outcomes.

Results

We analyzed 90 patients with BSI, including 40 with C. auris and 50 with other Candida species. All had been admitted to the intensive care unit (ICU). No significant demographic differences existed between the two groups. The following variables were independently associated with C. auris BSI: ≥ 15 days of pre-infection ICU stay (OR: 5.62, CI: 2.04–15.5), evidence of severe sepsis (OR: 3.70, CI 1.19–11.48), and diabetes mellitus (OR 5.69, CI 1.01–31.9).

Conclusion

Patients with C. auris BSI had longer lengths of ICU stay than those with other candidemias, suggesting that infections are acquired during hospitalization. This is different from other Candida infections, which are usually thought to result from autoinfection with host flora.

中文翻译：

---

念珠菌与其他念珠菌血流感染的病例比较：哥伦比亚的一次暴发调查结果。

背景

假丝酵母是一种新兴的耐多药酵母，可引起世界各地医疗机构的暴发。2016年，临床医生和公共卫生官员在哥伦比亚的医疗机构中鉴定出患有金黄色葡萄球菌血流感染（BSI）的患者。为了评估这些感染的潜在危险因素和结果，我们调查了金黄色葡萄球菌和其他念珠菌BSI患者的流行病学和临床特征。

方法

我们在四家哥伦比亚急症医院进行了回顾性病例调查，确定了一个病例为念珠菌属。于2015年1月至2016年9月从血液培养中分离得到。C. auris BSI病例与其他念珠菌BSI病例进行了比较。使用logistic回归估算的赔率（OR）用于评估风险因素与结果之间的关联。

结果

我们分析了90例BSI患者，其中40例患有耳孢菌，50例患有其他念珠菌。所有的人都被送进了重症监护室（ICU）。两组之间没有明显的人口统计学差异。以下变量独立与相关C.耳BSI：≥预感染ICU住宿15天（OR：5.62，CI：2.04-15.5），严重脓毒症的证据（OR为3.70，CI 1.19-11.48）和糖尿病（OR 5.69，CI 1.01-31.9）。

结论

与其他念珠菌病患者相比，金黄色葡萄球菌BSI患者的ICU住院时间更长，这表明在住院期间会感染。这与其他念珠菌感染不同，后者通常被认为是宿主菌群自身感染所致。