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First Cases of Candida auris in a Referral Intensive Care Unit in Piedmont Region, Italy
Candida auris is an emerging healthcare-associated infection that can easily cause dissemination in hospitals through colonizing the skin and contaminating environmental surfaces, especially in Intensive Care Units (ICU). Difficulties with identification of this organism, uncertainty about routes of...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9413117/ https://www.ncbi.nlm.nih.gov/pubmed/36013939 http://dx.doi.org/10.3390/microorganisms10081521 |
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author | Corcione, Silvia Montrucchio, Giorgia Shbaklo, Nour De Benedetto, Ilaria Sales, Gabriele Cedrone, Martina Vita, Davide Costa, Cristina Zozzoli, Susanna Zaccaria, Teresa Silvestre, Carlo Cavallo, Rossana Brazzi, Luca De Rosa, Francesco Giuseppe |
author_facet | Corcione, Silvia Montrucchio, Giorgia Shbaklo, Nour De Benedetto, Ilaria Sales, Gabriele Cedrone, Martina Vita, Davide Costa, Cristina Zozzoli, Susanna Zaccaria, Teresa Silvestre, Carlo Cavallo, Rossana Brazzi, Luca De Rosa, Francesco Giuseppe |
author_sort | Corcione, Silvia |
collection | PubMed |
description | Candida auris is an emerging healthcare-associated infection that can easily cause dissemination in hospitals through colonizing the skin and contaminating environmental surfaces, especially in Intensive Care Units (ICU). Difficulties with identification of this organism, uncertainty about routes of transmission and antifungals resistance have impacted significantly outbreak detection and management. Here, we describe our experience with colonization/infection of C. auris among critically ill patients, admitted to a referral ICU of a University Hospital, in a transitional period (July 2021–March 2022) between management of non-COVID-19 and COVID-19 patients due to the reconversion of the ICU between two waves. A total of 8 patients presented colonization from C. auris, and two of them developed invasive infection from C. auris. The fungal pathogen was cultured from different sites: the skin (7 isolates), urine (2), respiratory tract (1), blood (1). The median time from admission to first detection is 24 days with 100% of patients requiring mechanical ventilation. All 8 patients received broad-spectrum antibiotic therapy for bacterial infections before identification of C. auris; 62.5% of the patients had prior antifungal exposure; 87.5% received steroids; 37.5% patients used immunomodulatory; and 75% had severe COVID-19 illness prior to C. auris identification. Only two cases (25%) were treated with antifungals as C. auris infections (1 patient for suspected UTI; 1 patient with candidemia). Infection control measures, including rapid microbiological identification, contact isolation, screening of contacts, antisepsis of colonized patients, dedicated equipment, cleaning and disinfection of the environment and subsequent follow-up sampling, remain essential in critically ill patients. Our experience highlights the importance of establishing a multidisciplinary model and bundling of practices for preventing C. auris’ spread. |
format | Online Article Text |
id | pubmed-9413117 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-94131172022-08-27 First Cases of Candida auris in a Referral Intensive Care Unit in Piedmont Region, Italy Corcione, Silvia Montrucchio, Giorgia Shbaklo, Nour De Benedetto, Ilaria Sales, Gabriele Cedrone, Martina Vita, Davide Costa, Cristina Zozzoli, Susanna Zaccaria, Teresa Silvestre, Carlo Cavallo, Rossana Brazzi, Luca De Rosa, Francesco Giuseppe Microorganisms Article Candida auris is an emerging healthcare-associated infection that can easily cause dissemination in hospitals through colonizing the skin and contaminating environmental surfaces, especially in Intensive Care Units (ICU). Difficulties with identification of this organism, uncertainty about routes of transmission and antifungals resistance have impacted significantly outbreak detection and management. Here, we describe our experience with colonization/infection of C. auris among critically ill patients, admitted to a referral ICU of a University Hospital, in a transitional period (July 2021–March 2022) between management of non-COVID-19 and COVID-19 patients due to the reconversion of the ICU between two waves. A total of 8 patients presented colonization from C. auris, and two of them developed invasive infection from C. auris. The fungal pathogen was cultured from different sites: the skin (7 isolates), urine (2), respiratory tract (1), blood (1). The median time from admission to first detection is 24 days with 100% of patients requiring mechanical ventilation. All 8 patients received broad-spectrum antibiotic therapy for bacterial infections before identification of C. auris; 62.5% of the patients had prior antifungal exposure; 87.5% received steroids; 37.5% patients used immunomodulatory; and 75% had severe COVID-19 illness prior to C. auris identification. Only two cases (25%) were treated with antifungals as C. auris infections (1 patient for suspected UTI; 1 patient with candidemia). Infection control measures, including rapid microbiological identification, contact isolation, screening of contacts, antisepsis of colonized patients, dedicated equipment, cleaning and disinfection of the environment and subsequent follow-up sampling, remain essential in critically ill patients. Our experience highlights the importance of establishing a multidisciplinary model and bundling of practices for preventing C. auris’ spread. MDPI 2022-07-27 /pmc/articles/PMC9413117/ /pubmed/36013939 http://dx.doi.org/10.3390/microorganisms10081521 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Corcione, Silvia Montrucchio, Giorgia Shbaklo, Nour De Benedetto, Ilaria Sales, Gabriele Cedrone, Martina Vita, Davide Costa, Cristina Zozzoli, Susanna Zaccaria, Teresa Silvestre, Carlo Cavallo, Rossana Brazzi, Luca De Rosa, Francesco Giuseppe First Cases of Candida auris in a Referral Intensive Care Unit in Piedmont Region, Italy |
title | First Cases of Candida auris in a Referral Intensive Care Unit in Piedmont Region, Italy |
title_full | First Cases of Candida auris in a Referral Intensive Care Unit in Piedmont Region, Italy |
title_fullStr | First Cases of Candida auris in a Referral Intensive Care Unit in Piedmont Region, Italy |
title_full_unstemmed | First Cases of Candida auris in a Referral Intensive Care Unit in Piedmont Region, Italy |
title_short | First Cases of Candida auris in a Referral Intensive Care Unit in Piedmont Region, Italy |
title_sort | first cases of candida auris in a referral intensive care unit in piedmont region, italy |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9413117/ https://www.ncbi.nlm.nih.gov/pubmed/36013939 http://dx.doi.org/10.3390/microorganisms10081521 |
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