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Emerg Infect Dis. 2019 Sep;25(9):1698-1707. doi: 10.3201/eid2509.190040.

Epidemiologic Shift in Candidemia Driven by Candida auris, South Africa, 2016-20171.

Abstract

Candida auris is an invasive healthcare-associated fungal pathogen. Cases of candidemia, defined as illness in patients with Candida cultured from blood, were detected through national laboratory-based surveillance in South Africa during 2016-2017. We identified viable isolates by using mass spectrometry and sequencing. Among 6,669 cases (5,876 with species identification) from 269 hospitals, 794 (14%) were caused by C. auris. The incidence risk for all candidemia at 133 hospitals was 83.8 (95% CI 81.2-86.4) cases/100,000 admissions. Prior systemic antifungal drug therapy was associated with a 40% increased adjusted odds of C. auris fungemia compared with bloodstream infection caused by other Candida species (adjusted odds ratio 1.4 [95% CI 0.8-2.3]). The crude in-hospital case-fatality ratio did not differ between Candida species and was 45% for C. auris candidemia, compared with 43% for non-C. auris candidemia. C. auris has caused a major epidemiologic shift in candidemia in South Africa.

KEYWORDS:

Candida; Candida auris; South Africa; antifungal drug resistance; antimicrobial resistance; candidemia; fungi; multidrug resistance; mycoses

PMID:
31441749
PMCID:
PMC6711229
DOI:
10.3201/eid2509.190040
[Indexed for MEDLINE]
Free PMC Article

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