Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
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
_version_ 1784775657718284288
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
work_keys_str_mv AT corcionesilvia firstcasesofcandidaaurisinareferralintensivecareunitinpiedmontregionitaly
AT montrucchiogiorgia firstcasesofcandidaaurisinareferralintensivecareunitinpiedmontregionitaly
AT shbaklonour firstcasesofcandidaaurisinareferralintensivecareunitinpiedmontregionitaly
AT debenedettoilaria firstcasesofcandidaaurisinareferralintensivecareunitinpiedmontregionitaly
AT salesgabriele firstcasesofcandidaaurisinareferralintensivecareunitinpiedmontregionitaly
AT cedronemartina firstcasesofcandidaaurisinareferralintensivecareunitinpiedmontregionitaly
AT vitadavide firstcasesofcandidaaurisinareferralintensivecareunitinpiedmontregionitaly
AT costacristina firstcasesofcandidaaurisinareferralintensivecareunitinpiedmontregionitaly
AT zozzolisusanna firstcasesofcandidaaurisinareferralintensivecareunitinpiedmontregionitaly
AT zaccariateresa firstcasesofcandidaaurisinareferralintensivecareunitinpiedmontregionitaly
AT silvestrecarlo firstcasesofcandidaaurisinareferralintensivecareunitinpiedmontregionitaly
AT cavallorossana firstcasesofcandidaaurisinareferralintensivecareunitinpiedmontregionitaly
AT brazziluca firstcasesofcandidaaurisinareferralintensivecareunitinpiedmontregionitaly
AT derosafrancescogiuseppe firstcasesofcandidaaurisinareferralintensivecareunitinpiedmontregionitaly