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  1. Home /
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  3. Vol 50 No 4 (2019) /
  4. Case Report

Candida auris infection in the central catheter of a patient without sepsis symptoms

  • Abstract
  • Keywords
  • Author Biographies
  • References

Abstract

Background: Candida auris is an emerging yeast frequently reported as resistant to multiple antifungal drugs commonly used to treat Candida infections. This specie can colonize the patient’s skin and has great ability for producing outbreaks in hospitals. C. auris is phylogenetically related to other Candida species, can be misidentified using conventional biochemical or commercial methods and requires specific technology for its identification.

Case report: We report the first isolate of C. auris in Cali, Colombia, from a central venous catheter in a 37-year-old patient with rheumatoid arthritis and endocarditis who did not have symptoms of sepsis. The yeast was initially misidentified as C. haemulonii using the Phoenix® system and subsequently identified as C. auris by matrix-assisted laser desorption/ionization-time-of-flight (MALDI-TOF) mass spectrometry. The broth microdilution method was used to determine the minimum inhibitory concentration; the isolate was susceptible to fluconazole, itraconazole, voriconazole and amphotericin B.

Conclusions: This report contributes to knowledge of the epidemiology of C. auris infections in individuals with underlying disease and describes an isolate with a behavior different from what is usually reported.

Authors

  • Luz Angela Castro Universidad del Valle, Facultad de Salud, Escuela de Bacteriología y Laboratorio Clínico, Cali, Colombia https://orcid.org/0000-0002-0636-1486
  • María Inés Álvarez Universidad del Valle, Facultad de Salud, Departmento de Microbiología, Cali, Colombia. https://orcid.org/0000-0001-6033-166X
  • Gustavo Giusiano Universidad Nacional del Nordeste, Departamento de Micología, Instituto de Medicina Regional, CONICET, Resistencia, Argentina. https://orcid.org/0000-0003-4696-4158
  • Ernesto Martínez Universidad del Valle, Facultad de Salud, Departmento de Medicina Interna, Cali, Colombia https://orcid.org/0000-0002-0959-8593

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Keywords

  • Antifungal agents
  • Candida auris
  • central venous catheters
  • Colombia
  • MALDI-MS
  • minimum inhibitory concentration, yeast
  • Fluconazole
  • Amphotericin B
  • Itraconazole
  • Voriconazole
  • Endocarditis

Author Biographies


, Universidad del Valle, Facultad de Salud, Escuela de Bacteriología y Laboratorio Clínico, Cali, Colombia

orcid_id37.png https://orcid.org/0000-0002-0636-1486


, Universidad del Valle, Facultad de Salud, Departmento de Microbiología, Cali, Colombia.

orcid_id38.png  https://orcid.org/0000-0001-6033-166X


, Universidad Nacional del Nordeste, Departamento de Micología, Instituto de Medicina Regional, CONICET, Resistencia, Argentina.

orcid_id40.png https://orcid.org/0000-0003-4696-4158


, Universidad del Valle, Facultad de Salud, Departmento de Medicina Interna, Cali, Colombia

orcid_id39.png https://orcid.org/0000-0002-0959-8593

References

Jeffery-Smith A, Taori SK, Schelenz S, Jeffery K, Johnson EM, Borman A, et al. Candida auris: a review of the literature. Clin Microbiol Rev. 2018;31(1): e00029-17. https://doi.org/10.1128/CMR.00029-17

Center for Disease Control and Prevention. Clinical alert to U.S. healthcare facilities. Global emergence of invasive infections caused by the multidrug-resistant yeast Candida auris Atlanta; 2016. Fungal diseases. Available from: https://www.cdc.gov/fungal/diseases/candidiasis/candida-auris-alert.html

Satoh K, Makimura K, Hasumi Y, Nishiyama Y, Uchida K, Yamaguchi H. Candida auris sp. nov., a novel ascomycetous yeast isolated from the external ear canal of an inpatient in a Japanese hospital. Microbiol Immunol. 2009;53(1):41-4. https://doi.org/10.1111/j.1348-0421.2008.00083.x

Lone SA, Ahmad A. Candida auris-the growing menace to global health. Mycoses. 2019;62:620-637. https://doi.org/10.1111/myc.12904

Araúz AB, Caceres DH, Santiago E, Armstrong P, Arosemena S, Ramos C, et al. Isolation of Candida auris from 9 patients in Central America: Importance of accurate diagnosis and susceptibility testing. Mycoses. 2018;61(1):44-7. https://doi.org/10.1111/myc.12709

Escandón P, Chow NA, Caceres DH, Gade L, Berkow EL, Armstrong P, et al. Molecular epidemiology of Candida auris in Colombia reveals a highly related, country wide colonization with regional patterns in amphotericin B resistance. Clin Infect Dis. 2019;68(1):15-21. https://doi.org/10.1093/cid/ciy411

Arendrup MC, Prakash A, Meletiadis J, Sharma C, Chowdhary A. Comparison of EUCAST and CLSI Reference microdilution MICs of eight antifungal compounds for Candida auris and associated tentative epidemiological cutoff values. Antimicrob Agents Chemother. 2017;61(6): 61:e00485-17. https://doi.org/10.1128/AAC.00485-17

Center for Disease Control and Prevention. Recommendations for identification of Candida auris Atlanta; 2017. Fungal diseases. Available from: https://www.cdc.gov/fungal/diseases/candidiasis/recommendations.html

CLSI. Reference Method for Broth Dilution Antifungal susceptibility testing of yeasts; Fourth informational Supplement. CLSI document M27-S4. Wayne, PA: Clinical and Laboratory Standards Institute; 2012.

Morales-López SE, Parra-Giraldo CM, Ceballos-Garzón A, Martínez HP, Rodríguez GJ, Álvarez-Moreno CA, et al. Invasive infections with multidrug-resistant yeast Candida auris, Colombia. Emerging Infectious Diseases. 2017;23(1):162-4. https://doi.org/10.3201/eid2301.161497

Parra-Giraldo CM, Valderrama SL, Cortes-Fraile G, Garzón JR, Ariza BE, Morio F, et al First report of sporadic cases of Candida auris in Colombia. Int J Infect Dis. 2018;69:63-7. https://doi.org/10.1016/j.ijid.2018.01.034

Center for Disease Control and Prevention. Recommendations for infection prevention and control for Candida auris Atlanta; 2018. Fungal diseases. Available from: https://www.cdc.gov/fungal/candida-auris/c-auris-infection-control.html

Hata DJ, Humphries R, Lockhart SR. Candida auris: an emerging yeast pathogen posing distinct challenges for laboratory, diagnostics, treatment and infection prevention. Arch Pathol Lab Med. 2020;144:107-14. https://doi.org/10.5858/arpa.2018-0508-RA

Lockhart SR, Etienne KA, Vallabhaneni S, Farooqi J, Chowdhary A, Govender NP, et al. Simultaneous emergence of multidrug-resistant Candida auris on 3 continents confirmed by whole-genome sequencing and epidemiological analyses. Clin Infect Dis. 2017;64(2):134-40. https://doi.org/10.1093/cid/ciw691

Rozwadowski F, McAteer J, Chow NA, Skrobarcek K, Forsberg K, Barrett PM, et al. Prevalence and risk factors for Candida auris colonization among patients in a long-term acute care hospital-New Jersey, 2017. Open Forum Infect Dis. 2018; 5(Suppl 1): S14. https://doi.org/10.1093/ofid/ofy209.031

Sarma S, Upadhyay S. Current perspective on emergence, diagnosis and drug resistance in Candida auris. Infect Drug Resist. 2017;10:155-165. https://doi.org/10.2147/IDR.S116229

Cortegiani A, Misseri G, Fasciana T, Giammanco A, Giarratano A, Chowdhary A. Epidemiology, clinical characteristics, resistance, and treatment of infections by Candida auris. J Intensive Care. 2018; 29(6):69. https://doi.org/10.1186/s40560-018-0342-4

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Published
2019-12-30
Submitted
2020-03-12
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How to Cite
Castro, L., Álvarez, M., Giusiano, G., & Martínez, E. (2019). Candida auris infection in the central catheter of a patient without sepsis symptoms. Colombia Médica, 50(4), 293-98. https://doi.org/10.25100/cm.v50i4.4248
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Vol 50 No 4 (2019)
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Case Report

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