Clinical Outcomes Amongst Patients Infected With Candida Auris: A Single-Center Study.

Abstract

Candida auris (C. auris) is a therapeutic challenge due to the lack of definition of susceptibility breakpoints and the misidentification by biochemical tests, which leads to suboptimal therapy. Hence, our goal was to assess the treatment outcomes of C. auris infections at our institution.

Methods: A retrospective observational study between January 2019 and June 2022 that included confirmed C. auris infection cases. The primary endpoint was to assess the clinical outcomes of C. auris management. The secondary endpoints were to evaluate mycologic cure, 30 and 90-day infection recurrence, and 30-day all-cause mortality. Descriptive statistics were used to analyse our data.

Results: Fifty-six subjects were evaluated, with a mean age of 65.05 ± 16.86 years. Candidemia accounted for 62.7% of cases. Clinical cure was achieved in 57% of patients, and mycologic cure in 84.4%. Recurrence of C. auris infection occurred in 28.6% at 30 days and in 12.7% at 90 days. Thirty-day all-cause mortality occurred in 28.6% of patients. Multivariable logistic regression indicated that mycologic cure with Odds Ratio (OR) 6.96 (95% CI: 1.21-39.92), length in intensive care units (ICU) stay OR 0.132 (95% CI: 0.019-0.907), and baseline C-reactive protein (CRP) OR 0.990 (95% CI: 0.982-0.998) were the independent predictors of clinical cure.

Conclusion: Clinical cure of invasive C. auris infections was dependent on mycologic cure, length of ICU stays, and baseline CRP levels, with observed 30-day all-cause mortality up to 28.6%. Similarly to other reports, our isolates exhibited resistance to fluconazole and amphotericin B in most cases. Only two isolates demonstrated resistance to caspofungin and were deemed pan-resistant. Further multi-centre studies are needed to validate our findings.