The Dominance of Candida auris: A Single-center Experience of 79 Episodes of Candidemia from Western India

Introduction: Invasive candidiasis is a serious infection seen in hospitalized or immunocompromised patients. Mortality rates for candidemia can be as high as 30-60%. Candida auris is an emerging species of candida and is increasingly becoming a global public health problem. Methods: This was a retrospective observational study, in which we analyzed 79 episodes of candidemia. Blood cultures were done using the Bactec (TM) FX blood culturing Instrument (Becton, Dickinson and Company Sparks, Maryland, USA). Species identification was done using VITEK (R) 2 YST panels (bioMerieux Inc., Durham, North Carolina, USA). Antifungal susceptibility testing was performed using VITEK (R) 2 AST-YSO8 panels (bioMerieux Inc., Durham, North Carolina, USA). Results: Among the 79 episodes, the most common species was found to be C. auris (43.03% of all the episodes). Candida tropicalis was found to be the second most common species in patients admitted to our hospital with candidemia. All the isolates of C. auris were resistant to fluconazole, while 32.35% of the isolates were also resistant to amphotericin B. Crude mortality in patients with C. auris candidemia was higher than the crude mortality for the other species. Conclusion: This is the first study from India where C. auris was seen as the most predominant species among patients admitted with candidemia. This is a serious issue given the high rates of fluconazole resistance, mortality, and cost of therapy associated with C. awls bloodstream infections. Urgent attention needs to be diverted to infection control practices and antimicrobial stewardship programs.