Hospital-Associated Multicenter Outbreak of Emerging Fungus Candida auris, Colombia, 2016

Emerg Infect Dis. 2019 Jul;25(7):1339-1346. doi: 10.3201/eid2507.180491.

Abstract

Candida auris is an emerging multidrug-resistant fungus that causes hospital-associated outbreaks of invasive infections with high death rates. During 2015-2016, health authorities in Colombia detected an outbreak of C. auris. We conducted an investigation to characterize the epidemiology, transmission mechanisms, and reservoirs of this organism. We investigated 4 hospitals with confirmed cases of C. auris candidemia in 3 cities in Colombia. We abstracted medical records and collected swabs from contemporaneously hospitalized patients to assess for skin colonization. We identified 40 cases; median patient age was 23 years (IQR 4 months-56 years). Twelve (30%) patients were <1 year of age, and 24 (60%) were male. The 30-day mortality was 43%. Cases clustered in time and location; axilla and groin were the most commonly colonized sites. Temporal and spatial clustering of cases and skin colonization suggest person-to-person transmission of C. auris. These cases highlight the importance of adherence to infection control recommendations.

Keywords: Candida auris; Colombia; antimicrobial resistance; candidemia; fungi; healthcare-associated; nosocomial infections.

Publication types

  • Historical Article
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antifungal Agents / pharmacology
  • Antifungal Agents / therapeutic use
  • Candida* / drug effects
  • Candidemia / epidemiology
  • Candidemia / microbiology
  • Candidiasis / drug therapy
  • Candidiasis / epidemiology*
  • Candidiasis / history
  • Candidiasis / microbiology*
  • Child
  • Child, Preschool
  • Colombia / epidemiology
  • Communicable Diseases, Emerging / epidemiology*
  • Communicable Diseases, Emerging / history
  • Communicable Diseases, Emerging / microbiology*
  • Cross Infection*
  • Disease Outbreaks*
  • Drug Resistance, Fungal
  • Female
  • History, 21st Century
  • Humans
  • Infant
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Mortality
  • Patient Outcome Assessment
  • Public Health Surveillance
  • Seasons
  • Young Adult

Substances

  • Antifungal Agents