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. 2023 Mar 31;9(4):430.
doi: 10.3390/jof9040430.

The Mortality Attributable to Candidemia in C. auris Is Higher than That in Other Candida Species: Myth or Reality?

Carlos A Alvarez-Moreno  1 , Soraya Morales-López  2 , Gerson J Rodriguez  3 , Jose Y Rodriguez  3 , Estelle Robert  4 , Carine Picot  4 , Andrés Ceballos-Garzon  4   5 , Claudia M Parra-Giraldo  5 , Patrice Le Pape  4
Affiliations

The Mortality Attributable to Candidemia in C. auris Is Higher than That in Other Candida Species: Myth or Reality?

Carlos A Alvarez-Moreno et al. J Fungi (Basel). .

Abstract

Candida auris has become a major health threat due to its transmissibility, multidrug resistance and severe outcomes. In a case-control design, 74 hospitalised patients with candidemia were enrolled. In total, 22 cases (29.7%) and 52 controls (C. albicans, 21.6%; C. parapsilosis, 21.6%; C. tropicalis, 21.6%; C. glabrata, 1.4%) were included and analysed in this study. Risk factors, clinical and microbiological characteristics and outcomes of patients with C. auris and non-auris Candida species (NACS) candidemia were compared. Previous fluconazole exposure was significantly higher in C. auris candidemia patients (OR 3.3; 1.15-9.5). Most C. auris isolates were resistant to fluconazole (86.3%) and amphotericin B (59%) whilst NACS isolates were generally susceptible. No isolates resistant to echinocandins were detected. The average time to start antifungal therapy was 3.6 days. Sixty-three (85.1%) patients received adequate antifungal therapy, without significant differences between the two groups. The crude mortality at 30 and 90 days of candidemia was up to 37.8% and 40.5%, respectively. However, there was no difference in mortality both at 30 and 90 days between the group with candidemia by C. auris (31.8%) and by NACS (42.3%) (OR 0.6; 95% IC 0.24-1.97) and 36.4% and 42.3% (0.77; 0.27-2.1), respectively. In this study, mortality due to candidemia between C. auris and NACS was similar. Appropriate antifungal therapy in both groups may have contributed to finding no differences in outcomes.

Keywords: Candida auris; Colombia; candidemia; mortality.

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Conflict of interest statement

PLP received grants from Astellas, Basilea, MSD and Pfizer and speaker’s fees from Gilead, Basilea, Pfizer and MSD. All other authors declare no competing interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest.

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