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Volume 25, Number 7—July 2019
CME ACTIVITY - Research

Hospital-Associated Multicenter Outbreak of Emerging Fungus Candida auris, Colombia, 2016

Paige A. Armstrong1Comments to Author , Sandra M. Rivera1Comments to Author , Patricia Escandon, Diego H. Caceres, Nancy Chow, Matthew J. Stuckey, Jorge Díaz, Adriana Gomez, Norida Vélez, Andres Espinosa-Bode, Soraya Salcedo, Adriana Marin, Indira Berrio, Carmen Varón, Angel Guzman, Jairo E. Pérez-Franco, Julian D. Escobar, Nohora Villalobos, Juan M. Correa, Anastasia P. Litvintseva, Shawn R. Lockhart, Ryan Fagan, Tom M. Chiller, Brendan Jackson2, and Oscar Pacheco2
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P.A. Armstrong, D.H. Caceres, N. Chow, M.J. Stuckey, A. Espinosa-Bode, A.P. Litvintseva, S.R. Lockhart, R. Fagan, T.M. Chiller, B. Jackson); Instituto Nacional de Salud, Bogotá, Colombia (S.M. Rivera, P. Escandon, J. Díaz, A. Gomez, N. Vélez, O. Pacheco); Clínica General del Norte, Barranquilla, Colombia (S. Salcedo, A. Marin); Clínica El Rosario, Medellín, Colombia (I. Berrio); Corporación para Investigaciones Biológicas (CIB), Medellín (I. Berrio); Hospital General de Medellín, Medellín (I. Berrio); Hospital Doña Pilar, Cartagena, Colombia (C. Varón, A. Guzman); Hospital Militar Central, Bogotá (J.E. Pérez-Franco, J.D. Escobar); Clínica los Nogales, Bogotá (N. Villalobos, J.M. Correa)

Main Article

Table 1

Characteristics of 40 patients with Candida auris bloodstream infection, Colombia, 2015–2016*

Characteristic Value Data missing
Median age (IQR) 23 y (4 mo–56 y) 0
Infant up to 1 y 12 (30) 0
Child 1–18 y 8 (20) 0
Adult 18–65 y 14 (35) 0
Adult >65 y
 6 (15)
 0
Sex
   M 24 (60) 0
   F
 16 (40)
 0
Concurrent conditions 35 (88) 0
Chronic renal disease 9 (23) 0
Hemodialysis dependent 9 (23) 0
Diabetes 7 (18) 2
Immunosuppressive condition 6 (16) 3
Cancer 4 (11) 3
Solid tumor 2 (5) 4
Hematologic malignancy 2 (5) 4
Transplant 2 (5) 4
Neuromuscular condition
 1 (3)
 0
Outcome at 30 d
   Deceased 17 (43) 0
   Alive 21 (53) 0
   Hospitalized
 2 (5)
 0
In-hospital deaths
 23 (58)
 6
Admitted to hospital 40 (100) 0
Median inpatient stay, d (IQR) 46 (34–69) 3
Admitted to ICU 38 (100) 2
Median ICU stay, d (IQR) 36 (25–58) 10
Transferred from another facility
 16 (40)
 0
Previously hospitalized in the 90 d before admission
Yes 11 (28) 1
No 23 (59) 1
Unknown
 5 (13)
 1
Previous exposure to antifungal drugs
No 22 (67) 7
Unknown
 11 (33)
 7
Treatments and procedures
CVC 40 (100) 0
Vasopressors 31 (82) 2
Respiratory support 36 (100) 4
Intubation 35 (97) 4
Bilevel positive airway pressure 1 (3) 4
Surgical procedure 28 (70) 0
Total parenteral nutrition 19 (50) 2
Corticosteroids 18 (47) 2
Hemodialysis 15 (38) 1
Bronchoscopy 7 (19) 4
Chemotherapy
 4 (11)
 3
Median time from admission to C. auris positive culture, d (IQR) 22 (18–31) 0
Median time from CVC to C. auris positive culture, d (IQR)
 12 (5–21)
 1
Treatment for C. auris bloodstream infection 0
Fluconazole 16 (42)
Caspofungin 13 (34)
Amphotericin B 8 (21)
Voriconazole 1 (3)
No antifungal 2 (5)
>1 antifungal
 19 (48)
No. antibacterial drugs administered, median (range) 3.5 (1–6)

*Values are no. (%) patients except as indicated. CVC, central venous catheter; ICU, intensive care unit; IQR, interquartile range.

Main Article

1These authors contributed equally to this article.

2These authors contributed equally to this article.

Page created: June 13, 2019
Page updated: June 13, 2019
Page reviewed: June 13, 2019
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