• Alba Ruiz-Gaitán, Héctor Martínez, Ana María Moret, Eva Calabuig, María Tasias, Ana Alastruey-Izquierdo, Óscar Zaragoza, Joan Mollar, Juan Frasquet, Miguel Salavert-Lletí, Paula Ramírez, José Luis López-Hontangas, and Javier Pemán.
• a Severe Infection Research Group, Medical Research Institute La Fe , Valencia , Spain.
• Expert Rev Anti Infect Ther. 2019 Apr 1; 17 (4): 295-305.

BackgroundCandida auris is an emerging, multidrug-resistant yeast causing hospital outbreaks. This study describes the first 24 months of the ongoing C. auris outbreak in our hospital and analyzes predisposing factors to C. auris candidemia/colonization.Research Design And MethodsA 12-month prospective, case-controlled study was performed including a total of 228 patients (114 colonized/candidemia and 114 controls). Data from the first 79 candidemia episodes and 738 environmental samples were also analyzed. Definitive C. auris identification was performed by ITS sequencing. Antifungal susceptibility was carried out by EUCAST methodology.ResultsPolytrauma (32%), cardiovascular disease (25%), and cancer (17%) were the most common underlying condition in colonized/candidemia patients. Indwelling CVC (odds ratio {OR}, 13.48), parenteral nutrition (OR, 3.49), and mechanical ventilation (OR, 2.43) remained significant predictors of C. auris colonization/candidemia. C. auris was most often isolated on sphygmomanometer cuffs (25%) patient tables (10.2%), keyboards (10.2%), and infusion pumps (8.2%). All isolates were fully resistant to fluconazole (MICs >64 mg/L) and had significantly reduced susceptibility to voriconazole (GM, 1.8 mg/L).ConclusionsPredictor conditions to C. auris colonization/candidemia are similar to other Candida species. C. auris colonizes multiple patient's environment surfaces. All isolates are resistant to fluconazole and had significant reduced susceptibility to voriconazole.

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