Fundación Cardiovascular de Colombia, Bucaramanga, Colombia.
Anschutz Medical Center, University of Colorado, Aurora, Colorado, USA.
J Pediatric Infect Dis Soc. 2021 May 28;10(5):549-555. doi: 10.1093/jpids/piaa152.
Globally, Candida auris is an emerging pathogen that poses an essential threat in healthcare settings presenting as outbreaks requiring significant allocation of infection control interventions to curb transmission. This fungal pathogen was initially identified in 2009 in Japan, but it has spread to all continents. Candida auris poses significant diagnostic and treatment challenges. Conventional microbiology laboratories often misidentify this pathogen as Candida haemulonii or as other Candida spp., Rhodoturola glutinis, and even with some bacterial pathogens, including Neisseria meningitidis serogroup A. Furthermore, C. auris displays distinct mechanisms of antifungal resistance to azoles and amphotericin B formulations. Most of the case series and outbreak reports have included invasive infections in adult populations.
Herein, we present a cluster of neonatal infections caused by Candida auris at a large referral center in Colombia.
We report a case series of 8 neonates and infant patients who were seen at a large referral center in Colombia and who develop invasive infections caused by C. haemulonii and C. auris.
Our report highlights the diagnostic challenges in identifying this fungal pathogen correctly, its clinical spectrum of disease, recommendations for empiric antifungal therapy, and it is not always associated with a high case fatality rate.
全球范围内,Candida auris 是一种新兴的病原体,在医疗机构中呈爆发式流行,对感染控制干预措施提出了重要要求,以遏制其传播。这种真菌病原体最初于 2009 年在日本被发现,但现已传播至各大洲。Candida auris 带来了重大的诊断和治疗挑战。常规微生物学实验室常将其误鉴定为 Candida haemulonii 或其他 Candida spp.、Rhodoturola glutinis,甚至包括一些细菌病原体,如脑膜炎奈瑟菌 A 群。此外,C. auris 对唑类和两性霉素 B 制剂表现出独特的抗真菌耐药机制。大多数病例系列和暴发报告均包含成人侵袭性感染。
在此,我们介绍了哥伦比亚一家大型转诊中心发生的一组由 Candida auris 引起的新生儿感染。
我们报告了一系列 8 例在哥伦比亚一家大型转诊中心就诊的新生儿和婴儿患者的病例,他们患有由 C. haemulonii 和 C. auris 引起的侵袭性感染。
我们的报告强调了正确识别这种真菌病原体的诊断挑战、其疾病谱、经验性抗真菌治疗建议,而且其并非总是与高病死率相关。