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. 2020 Sep;21(5):189-195.
doi: 10.1177/1757177420935639. Epub 2020 Jun 30.

Outbreak investigation of Candida auris at a tertiary care hospital in Karachi, Pakistan

Joveria Q Farooqi  1 , Asad S Soomro  2 , Mirza A Baig  2 , Shamoona F Sajjad  2 , Kamran Hamid  2 , Kauser Jabeen  1 , Mohammed F Naqvi  1 , Nosheen Nasir  3 , Rozina Roshan  4 , Syed F Mahmood  3 , Afia Zafar  1 , Rana J Asghar  5
Affiliations

Outbreak investigation of Candida auris at a tertiary care hospital in Karachi, Pakistan

Joveria Q Farooqi et al. J Infect Prev. 2020 Sep.

Abstract

Background: From September 2014, a tertiary care hospital in Karachi, Pakistan, started diagnosing 3-5 cases/month of a yeast locally identified as Saccharomyces spp. resistant to fluconazole. US Centers for Disease Control and Prevention identified the isolates as Candida auris. The Pakistan Field Epidemiology and Laboratory Training Program (FELTP) and the hospital investigated the outbreak from April 2015 to January 2016.

Objective: The aim of the outbreak investigation was to determine the risk factors and to inform measures to limit the spread of the organism in the hospital.

Methods: Medical records, nursing schedules and infection control practices were reviewed. Sixty-two age- and sex-matched hospital controls from the same wards were identified.

Results: Thirty cases (17 males) were identified (mean age = 51.6 years, age range = 2-91 years), case fatality was 53%. Multivariate logistic regression showed that a history of surgery within 90 days of diagnosis, admission to the emergency department and history of chronic kidney disease were significantly associated with C. auris infection.

Discussion: This is the report of the outbreak investigation that triggered a global exploration of C. auris as a newly identified multidrug-resistant nosocomial organism, spreading within the hospital, especially among patients with invasive procedures. Unfortunately, we could not identify any specific source of the outbreak nor stop the transmission of the organism.

Keywords: Candida auris; fluconazole resistant; infection control; outbreak investigation.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Epi Curve showing month-wise case distribution of C. auris from October 2014 to November 2015 at our University Hospital in Karachi.
See this image and copyright information in PMC

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