Title

C. auris and non-C. auris candidemia in hospitalized adult and pediatric COVID-19 patients; single center data from Pakistan

Document Type

Article

Department

Pathology and Laboratory Medicine; Department of Medicine

Abstract

We compared candidemia due to Candida auris and other non-C.auris cases in hospitalized COVID-19 patients over a period of nine months at our institution. Candidemia cases in all admitted patients (with or without COVID-19) from April-December 2020 were identified. Electronic records were accessed to record clinical data of COVID-19 patients with candidemia. For statistical analysis, independent samples Mann-Whitney U test was used for continuous and Fisher's exact test was used for categorical variables.A total of 26 candidemia cases (four C.auris, 22 non-C.auris) in 2438 admitted COVID-19 (10.7 per 1000 admissions) and 59 candidemia cases (six C.auris, 53 non-C.auris) in admitted non-COVID patients (8.2 per 1000 admission) were identified. The proportion of C.auris candidemia in COVID-19 and non-COVID-19 patients was 15.4% and 10% respectively. 4/26 of COVID-19 candidemia patients were aged ≤ 15 years (10 months-15 years). Comparison of C.auris and non-C.auris candidemia cases reveal significant difference in prior antifungal exposure, present in 100% C.auris candidemia versus 27% non-C.auris candidemia patients (p-value 0.014). Although not statistically significant, C.auris candidemia patients had a longer stay in hospital before candidemia (20 vs 9 days), higher isolation rate of multidrug resistant bacteria (100% vs 50%), increased rate of prior colonization of Candida species (50% vs 14%) and lower mean beta-d-glucan levels (48.73 pg/mL vs. 138.146 pg/mL). Both C.auris and non-C.auris COVID-19 patients had similar mortality rate (67% vs 65%). A significant number of critically ill COVID-19 patients developed candidemia in our study highlighting the need for prompt diagnosis and management.
Lay summary: 26 candidemia cases (4 Candida auris;22 non-C.auris) in COVID-19 patients (April-December 2020) are reported from Pakistan. Compared to non-C.auris, C.auris candidemia patients had higher prior antifungal exposure, longer hospital stay, higher MDR bacteria and increased rate of Candida colonization.

Comments

Volume, issue, and pagination are not provided by the author/publisher

Publication

Medical Mycology

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