First report of sporadic cases of Candida auris in Colombia
Résumé
Background: Candida auris is a recently reported Candida species that is phenotypically similar to Candidahaemulonii and related to hospital outbreaks. This organism can be misidentified as Candida haemulonii,Candida famata, Candida catenulata, or Rhodotorula glutinis by phenotypic approaches. Matrix-assistedlaser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and DNA sequenceanalysis using internal transcribed spacer rDNA bar-coding provide an accurate identification.Case reports: Three cases of C. auris infection in patients with risk factors for fungal infection (oneadmitted to the intensive care unit, one with lymphoma, and one with HIV; all three with previousantibiotic use) are reported; these infections were not epidemiologically related. Yeast isolates wererecovered from blood, ocular secretion, and bronchoalveolar lavage and were misidentified as C.catenulata and Candida albicans by the phenotypic MicroScan method. The isolates were confirmed to beC. auris by means of MALDI-TOF MS and DNA sequence analysis. Antifungal susceptibility testing wasperformed on these C. auris isolates, which exhibited high minimum inhibitory concentrations totriazoles and amphotericin B. One patient survived and the other two died. Only one of these deaths wasrelated to fungemia.Conclusions: C. auris is an emerging and opportunistic multidrug-resistant human pathogen. It isnecessary to strengthen measures to achieve an accurate and quick identification and also to avoid itsdissemination. This will require improvements in health and infection control measures, as well as thepromotion of antifungal stewardship in healthcare facilities.
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