Do bloodstream infections caused by Candida auris have high mortality risk?

USA: A new study published in the journal Clinical Infectious Diseases found no difference in the risk of fatality when comparing bloodstream infections (BSI) caused by Candida Auris to BSI caused by other Candida spp.

Bloodstream infections are conditions when bacteria, fungus, viruses, and parasites are found in normally sterile blood. Innumerable combinations of these bacteria are possible, leading to many different descriptions of BSIs, such as monomicrobial (containing a single microbial etiology) or polymicrobial (using a combination of microbial etiologies). Over 90% of BSIs from fungi are caused by candida. They have been placed third among late-onset sepsis etiologies in newborns and fourth among BSIs observed in the United States of America and Europe, respectively. Samuel P. Simon and colleagues undertook this study in order to examine the clinical traits and consequences of bloodstream infections brought on by Candida Auris and other Candida spp.

Three hospitals in Brooklyn, New York participated in this retrospective, case-control research between 2016 and 2020. Patients under the age of 18 who had received echinocandin treatment ad hoc for any Candida spp. with a positive blood culture were included in the study. 30-day mortality was the main result. 14-day clinical failure, 90-day death, 60-day microbiologic recurrence, and in-hospital mortality were considered secondary outcomes.

The key findings of this study were:

1. The final analysis comprised 196 individuals, including 83 instances of candidemia brought on by C. Auris.

2. Inverse propensity adjustment revealed that C. Auris BSI was not linked to higher chances of 30-day or 90-day death (aOR 1.014 and 0.863  respectively).

3. Patients with C. Auris had a greater risk of microbiologic recurrence within 60 days after finishing antifungal medication (aOR 4.461).

In conclusion, the outcome of this study clearly suggests that in the C. Auris group, the chance of microbiologic recurrence was greater.

Reference: 

Simon, S. P., Li, R., Silver, M., Andrade, J., Tharian, B., Fu, L., Villanueva, D., Abascal, D. G., Mayer, A., Truong, J., Figueroa, N., Ghitan, M., Chapnick, E., & Lin, Y. S. (2022). Comparative Outcomes of Candida auris Bloodstream Infections: A Multicenter Retrospective Case-control Study. In Clinical Infectious Diseases. Oxford University Press (OUP). https://doi.org/10.1093/cid/ciac735