Abstract：
BACKGROUND: Candida auris, a multidrug-resistant fungal pathogen, has received considerable attention owing to its recent surge, especially in South America, which coincides with the ongoing global COVID-19 pandemic. Understanding the clinical and microbiological characteristics of outbreaks is crucial for their effective management and control.
OBJECTIVE: This retrospective observational study aimed to characterize a C. auris outbreak at a Peruvian referral hospital between January 2021 and July 2023.
METHODS: Data were collected from hospitalized patients with positive C. auris culture results. Microbiological data and antifungal susceptibility test results were analysed. Additionally, infection prevention and control measures have been described. Statistical analysis was used to compare the characteristics between the infected and colonized patients.
RESULTS: Thirty-three patients were identified, mostly male (66.7%), with a median age of 53 years. Among them, 18 (54.5%) were colonized, and 15 (45.5%) were infected. Fungemia was the predominant presentation (80%), with notable cases of fungemia in tuberculosis patients with long-stay devices for parenteral anti-tuberculosis therapy. Seventy-five percent of the isolates exhibited fluconazole resistance. Echinocandins were the primary treatment, preventing fungemia recurrence within 30 days. Infected patients had significantly longer hospital stays than colonized patients (100 vs. 45 days; p = .023). Hospital mortality rates were 46.7% and 25% in the infected and fungemia patients, respectively. Simultaneous outbreaks of multidrug-resistant bacteria were documented.
CONCLUSIONS: This study underscores the severity of a C. auris outbreak at a referral hospital in Peru, highlighting its significant impact on patient outcomes and healthcare resources. The high prevalence of fluconazole-resistant isolates, leading to prolonged hospital stay and high mortality rates, particularly in cases of fungemia, underscores the critical need for effective infection prevention and control strategies.
OBJECTIVE: This retrospective observational study aimed to characterize a C. auris outbreak at a Peruvian referral hospital between January 2021 and July 2023.
METHODS: Data were collected from hospitalized patients with positive C. auris culture results. Microbiological data and antifungal susceptibility test results were analysed. Additionally, infection prevention and control measures have been described. Statistical analysis was used to compare the characteristics between the infected and colonized patients.
RESULTS: Thirty-three patients were identified, mostly male (66.7%), with a median age of 53 years. Among them, 18 (54.5%) were colonized, and 15 (45.5%) were infected. Fungemia was the predominant presentation (80%), with notable cases of fungemia in tuberculosis patients with long-stay devices for parenteral anti-tuberculosis therapy. Seventy-five percent of the isolates exhibited fluconazole resistance. Echinocandins were the primary treatment, preventing fungemia recurrence within 30 days. Infected patients had significantly longer hospital stays than colonized patients (100 vs. 45 days; p = .023). Hospital mortality rates were 46.7% and 25% in the infected and fungemia patients, respectively. Simultaneous outbreaks of multidrug-resistant bacteria were documented.
CONCLUSIONS: This study underscores the severity of a C. auris outbreak at a referral hospital in Peru, highlighting its significant impact on patient outcomes and healthcare resources. The high prevalence of fluconazole-resistant isolates, leading to prolonged hospital stay and high mortality rates, particularly in cases of fungemia, underscores the critical need for effective infection prevention and control strategies.
摘要：
背景：念珠菌，一种多重耐药的真菌病原体，由于最近的激增，受到了相当大的关注，尤其是在南美洲，这与正在进行的全球COVID-19大流行相吻合。了解暴发的临床和微生物学特征对于其有效管理和控制至关重要。
目的：这项回顾性观察性研究旨在描述2021年1月至2023年7月在秘鲁转诊医院发生的一次C.auris疫情。
方法：数据来自金耳梭菌培养结果阳性的住院患者。分析了微生物数据和抗真菌药敏试验结果。此外,对感染的预防和控制措施进行了阐述。统计分析用于比较感染和定植患者之间的特征。
结果：确定了33例患者，主要是男性(66.7%)，平均年龄为53岁。其中,18（54.5％）被定植，15人(45.5%)感染。真菌血症是主要表现（80％），在长期使用肠胃外抗结核治疗设备的结核病患者中，有明显的真菌血症病例。75％的分离株表现出氟康唑耐药性。棘球白素是主要的治疗方法,预防30天内真菌血症复发。感染患者的住院时间明显长于定植患者（100vs.45天；p=.023）。感染和真菌血症患者的医院死亡率分别为46.7%和25%,分别。记录了同时爆发的多药耐药细菌。
结论：这项研究强调了秘鲁一家转诊医院发生的一次C.auris爆发的严重程度，强调其对患者预后和医疗保健资源的重大影响。氟康唑耐药菌株的高患病率，导致住院时间延长和死亡率高，特别是在真菌血症的情况下，强调迫切需要有效的感染预防和控制策略。
目的：这项回顾性观察性研究旨在描述2021年1月至2023年7月在秘鲁转诊医院发生的一次C.auris疫情。
方法：数据来自金耳梭菌培养结果阳性的住院患者。分析了微生物数据和抗真菌药敏试验结果。此外,对感染的预防和控制措施进行了阐述。统计分析用于比较感染和定植患者之间的特征。
结果：确定了33例患者，主要是男性(66.7%)，平均年龄为53岁。其中,18（54.5％）被定植，15人(45.5%)感染。真菌血症是主要表现（80％），在长期使用肠胃外抗结核治疗设备的结核病患者中，有明显的真菌血症病例。75％的分离株表现出氟康唑耐药性。棘球白素是主要的治疗方法,预防30天内真菌血症复发。感染患者的住院时间明显长于定植患者（100vs.45天；p=.023）。感染和真菌血症患者的医院死亡率分别为46.7%和25%,分别。记录了同时爆发的多药耐药细菌。
结论：这项研究强调了秘鲁一家转诊医院发生的一次C.auris爆发的严重程度，强调其对患者预后和医疗保健资源的重大影响。氟康唑耐药菌株的高患病率，导致住院时间延长和死亡率高，特别是在真菌血症的情况下，强调迫切需要有效的感染预防和控制策略。
