Tags

Type your tag names separated by a space and hit enter

Invasive Candida auris infections in Kuwait hospitals: epidemiology, antifungal treatment and outcome.
Infection 2018; 46(5):641-650I

Abstract

PURPOSE

Candida auris is a recently recognized yeast pathogen, which has attracted worldwide attention due to its multidrug-resistant nature and associated high mortality rates. Its persistence in hospital environment and propensity of nosocomial transmission underscores the need of continuous monitoring to prevent outbreaks. Since the first case of C. auris candidemia in May, 2014, we have identified 17 additional invasive cases, which are described here.

METHODS

Identity of 17 isolates originating from proven or possible cases of invasive C. auris infection and identified as Candida haemulonii by Vitek 2 yeast identification system was confirmed by PCR-sequencing of rDNA. Information about risk factors, treatment and outcomes were retrospectively retrieved from case files. Antifungal susceptibility testing was performed by Etest.

RESULTS

Thirteen cases of candidemia and 4 cases of other invasive infections were detected in 6 hospitals across Kuwait. Major risk factors included adult patients with cancer, diabetes, gastrointestinal/liver diseases and extended (> 25 days) hospital stay. All isolates were resistant to fluconazole. Additionally, 5 and 4 isolates were also resistant to voriconazole and amphotericin B, respectively. Despite antifungal treatment, 9 of 15 patients died. Most patients (n = 12) were hospitalized in 2 hospitals that are in close proximity, whereas 5 other patients were from 3 hospitals that are situated > 10 km apart.

CONCLUSIONS

Occurrence of successive cases of invasive C. auris infections with resulting mortality in nine patients suggests persistence of this multidrug-resistant yeast in major hospitals in Kuwait. Early detection by continuous surveillance and enforcement of infection control measures are recommended.

Authors+Show Affiliations

Department of Microbiology, Faculty of Medicine, Kuwait University, P. O. Box 24923, Safat, 13110, Kuwait City, Kuwait. zkhan@hsc.edu.kw. Department of Microbiology, Mubarak Al-Kabeer Hospital, Jabriya, Kuwait. zkhan@hsc.edu.kw.Department of Microbiology, Faculty of Medicine, Kuwait University, P. O. Box 24923, Safat, 13110, Kuwait City, Kuwait. Department of Microbiology, Mubarak Al-Kabeer Hospital, Jabriya, Kuwait.Department of Microbiology, Al-Amiri Hospital, Kuwait City, Kuwait.Department of Microbiology, Al-Sabah Hospital, Kuwait City, Kuwait.Department of Microbiology, Al-Sabah Hospital, Kuwait City, Kuwait.Department of Microbiology, Al-Sabah Hospital, Kuwait City, Kuwait.Department of Microbiology, Al-Sabah Hospital, Kuwait City, Kuwait.Department of Microbiology, Faculty of Medicine, Kuwait University, P. O. Box 24923, Safat, 13110, Kuwait City, Kuwait. Department of Microbiology, Ibn-Sina Hospital, Kuwait City, Kuwait.Department of Microbiology, Ibn-Sina Hospital, Kuwait City, Kuwait.Department of Microbiology, Mubarak Al-Kabeer Hospital, Jabriya, Kuwait.Department of Microbiology, Faculty of Medicine, Kuwait University, P. O. Box 24923, Safat, 13110, Kuwait City, Kuwait.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29949089

Citation

Khan, Ziauddin, et al. "Invasive Candida Auris Infections in Kuwait Hospitals: Epidemiology, Antifungal Treatment and Outcome." Infection, vol. 46, no. 5, 2018, pp. 641-650.
Khan Z, Ahmad S, Benwan K, et al. Invasive Candida auris infections in Kuwait hospitals: epidemiology, antifungal treatment and outcome. Infection. 2018;46(5):641-650.
Khan, Z., Ahmad, S., Benwan, K., Purohit, P., Al-Obaid, I., Bafna, R., ... Joseph, L. (2018). Invasive Candida auris infections in Kuwait hospitals: epidemiology, antifungal treatment and outcome. Infection, 46(5), pp. 641-650. doi:10.1007/s15010-018-1164-y.
Khan Z, et al. Invasive Candida Auris Infections in Kuwait Hospitals: Epidemiology, Antifungal Treatment and Outcome. Infection. 2018;46(5):641-650. PubMed PMID: 29949089.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Invasive Candida auris infections in Kuwait hospitals: epidemiology, antifungal treatment and outcome. AU - Khan,Ziauddin, AU - Ahmad,Suhail, AU - Benwan,Khalifa, AU - Purohit,Prashant, AU - Al-Obaid,Inaam, AU - Bafna,Ritu, AU - Emara,Maha, AU - Mokaddas,Eiman, AU - Abdullah,Aneesa Ahmed, AU - Al-Obaid,Khaled, AU - Joseph,Leena, Y1 - 2018/06/14/ PY - 2018/04/19/received PY - 2018/06/11/accepted PY - 2018/6/28/pubmed PY - 2019/1/15/medline PY - 2018/6/28/entrez KW - Antifungal susceptibility KW - Candida auris KW - Epidemiology KW - Invasive infections KW - Kuwait SP - 641 EP - 650 JF - Infection JO - Infection VL - 46 IS - 5 N2 - PURPOSE: Candida auris is a recently recognized yeast pathogen, which has attracted worldwide attention due to its multidrug-resistant nature and associated high mortality rates. Its persistence in hospital environment and propensity of nosocomial transmission underscores the need of continuous monitoring to prevent outbreaks. Since the first case of C. auris candidemia in May, 2014, we have identified 17 additional invasive cases, which are described here. METHODS: Identity of 17 isolates originating from proven or possible cases of invasive C. auris infection and identified as Candida haemulonii by Vitek 2 yeast identification system was confirmed by PCR-sequencing of rDNA. Information about risk factors, treatment and outcomes were retrospectively retrieved from case files. Antifungal susceptibility testing was performed by Etest. RESULTS: Thirteen cases of candidemia and 4 cases of other invasive infections were detected in 6 hospitals across Kuwait. Major risk factors included adult patients with cancer, diabetes, gastrointestinal/liver diseases and extended (> 25 days) hospital stay. All isolates were resistant to fluconazole. Additionally, 5 and 4 isolates were also resistant to voriconazole and amphotericin B, respectively. Despite antifungal treatment, 9 of 15 patients died. Most patients (n = 12) were hospitalized in 2 hospitals that are in close proximity, whereas 5 other patients were from 3 hospitals that are situated > 10 km apart. CONCLUSIONS: Occurrence of successive cases of invasive C. auris infections with resulting mortality in nine patients suggests persistence of this multidrug-resistant yeast in major hospitals in Kuwait. Early detection by continuous surveillance and enforcement of infection control measures are recommended. SN - 1439-0973 UR - https://www.unboundmedicine.com/medline/citation/29949089/Invasive_Candida_auris_infections_in_Kuwait_hospitals:_epidemiology_antifungal_treatment_and_outcome_ L2 - https://doi.org/10.1007/s15010-018-1164-y DB - PRIME DP - Unbound Medicine ER -