First case of Candida auris infection in Belgium in a surgical patient from Kuwait

Affiliations


Abstract

Objective and importance: Candida auris is a relatively new yeast species and an emerging opportunistic pathogen. It was first reported in 2009 in East Asia, as a difficult-to-identify Candida species of uncertain clinical relevance. In recent years, it has appeared globally as a cause of invasive infections, not infrequently eliciting nosocomial outbreaks. Species identification in clinical laboratories has been challenging, as traditional phenotypic and biochemical methods have been generally unreliable. Clinical management is often complicated by multidrug resistance in many isolates. Additionally, C. auris has demonstrated an unusual ability for persistence in the hospital environment and in asymptomatic patients. We present the first Belgian case of C. auris infection along with a brief review of the literature.Clinical presentation: A patient was referred from Kuwait for surgical treatment after a complicated bariatric procedure. Few days after transferral, she developed a catheter-related blood stream infection with C. auris. We obtained a low-confidence identification of C. auris with the Bruker Biotyper MALDI-TOF MS system (Bruker Corporation, Billerica, MA, U.S.A.), and of Candida haemulonii with the Vitek YST identification system, version 7.01 (bioMérieux, Marcy-L'Etoile, France). Definite identification was obtained using Internal Transcribed Spacer (ITS) sequencing. As most C. auris isolates, our strain was resistant to fluconazole, and the patient was eventually treated with catheter removal and anidulafungin therapy. We documented persistence of C. auris clones with acquired echinocandin resistance in our patient up to 18 months after the infection.Conclusion: Clinicians and microbiologists should be aware of this globally emerging yeast, that poses important challenges in identification, treatment and hospital infection control.

Keywords: Antifungal resistance; Candida auris; Infection control; MALDI-TOF.


Similar articles

Invasive Candida auris infections in Kuwait hospitals: epidemiology, antifungal treatment and outcome.

Khan Z, Ahmad S, Benwan K, Purohit P, Al-Obaid I, Bafna R, Emara M, Mokaddas E, Abdullah AA, Al-Obaid K, Joseph L.Infection. 2018 Oct;46(5):641-650. doi: 10.1007/s15010-018-1164-y. Epub 2018 Jun 14.PMID: 29949089

Increasing prevalence, molecular characterization and antifungal drug susceptibility of serial Candida auris isolates in Kuwait.

Khan Z, Ahmad S, Al-Sweih N, Joseph L, Alfouzan W, Asadzadeh M.PLoS One. 2018 Apr 9;13(4):e0195743. doi: 10.1371/journal.pone.0195743. eCollection 2018.PMID: 29630658 Free PMC article.

Are We Ready for Nosocomial Candida auris Infections? Rapid Identification and Antifungal Resistance Detection Using MALDI-TOF Mass Spectrometry May Be the Answer.

De Carolis E, Marchionni F, La Rosa M, Meis JF, Chowdhary A, Posteraro B, Sanguinetti M.Front Cell Infect Microbiol. 2021 Mar 16;11:645049. doi: 10.3389/fcimb.2021.645049. eCollection 2021.PMID: 33796487 Free PMC article.

Candida auris, what do paediatricians need to know?

Warris A.Arch Dis Child. 2018 Sep;103(9):891-894. doi: 10.1136/archdischild-2017-313960. Epub 2018 Mar 15.PMID: 29545411 Free PMC article. Review.

Diagnosis, management and prevention of Candida auris in hospitals: position statement of the Australasian Society for Infectious Diseases.

Ong CW, Chen SC, Clark JE, Halliday CL, Kidd SE, Marriott DJ, Marshall CL, Morris AJ, Morrissey CO, Roy R, Slavin MA, Stewardson AJ, Worth LJ, Heath CH; Australian and New Zealand Mycoses Interest Group (ANZMIG); and the Healthcare Infection Control Special Interest Group (HICSIG); both of the Australasian Society for Infectious Diseases (ASID).Intern Med J. 2019 Oct;49(10):1229-1243. doi: 10.1111/imj.14612.PMID: 31424595 Review.


References

https://pubmed.ncbi.nlm.nih.gov/