Infection à Candida auris

Candida auris is a newly recognized fungal species and emerging opportunistic pathogen that is difficult to identify using traditional phenotypic and biochemical laboratory methods ^[3]. It is characterized by multidrug resistance, substantial medication resistance, and easy transmission within hospital environments ^[2][3]. The organism was first isolated in 2009 from the ear canal of an elderly Japanese patient and has since become a globally distributed cause of invasive infections ^[2][3].

In healthcare settings, C. auris manifests as invasive infections including candidaemia and catheter-related bloodstream infection, with non-specific signs and frequent multidrug resistance ^[3][4]. In neonatal populations, systemic infection presents with high mortality (approximately 42%) and frequent fluconazole (97.4%) and amphotericin B (67.1%) resistance ^[1]. The organism demonstrates unusual persistence in hospital environments and in asymptomatic patients, with clones showing acquired echinocandin resistance persisting for months ^[3].

A global epidemiological shift in candidemia has been marked by emergence of resistant non-albicans species, with C. auris causing infections in pediatric and adult populations within healthcare settings ^[1]. A systematic review identified 476 neonatal cases across 24 studies published through December 2023, with prematurity as a primary risk factor ^[1]. The pathogen has appeared globally as a cause of invasive infections and nosocomial outbreaks since its first report in 2009 ^[3].

C. auris exhibits easy transmission within hospitals and an unusual ability to persist in the healthcare environment and in asymptomatic colonized patients ^[2]. Documented healthcare-associated acquisition includes catheter-related bloodstream infection in transferred surgical patients and neonatal intensive-care exposures ^[1].

Effective prevention and control of C. auris in healthcare institutions is hindered by lack of standardized strategies and appropriate treatment options, contributing to treatment failures and persistence ^[2]. Comprehensive preparedness in patient care is necessary given global occurrence, particularly in neonatal and intensive-care settings where central lines, ventilation, and broad-spectrum antibiotics are risk-associated ^[1].

1. 1 Sokou R et al. Candida auris Infection, a Rapidly Emerging Threat in the Neonatal Intensive Care Units: A Systematic Review. J Clin Med. 2024 Mar 10. PMID: 38541815. doi: 10.3390/jcm13061586. PubMed: https://pubmed.ncbi.nlm.nih.gov/38541815/
2. 2 Hong H et al. Candida auris infection; diagnosis, and resistance mechanism using high-throughput sequencing technology: a case report and literature review. Front Cell Infect Microbiol. 2023. PMID: 38145050. doi: 10.3389/fcimb.2023.1211626. PubMed: https://pubmed.ncbi.nlm.nih.gov/38145050/
3. 3 Dewaele K et al. First case of Candida auris infection in Belgium in a surgical patient from Kuwait. Acta Clin Belg. 2020 Jun. PMID: 30514182. doi: 10.1080/17843286.2018.1555114. PubMed: https://pubmed.ncbi.nlm.nih.gov/30514182/
4. 4 Lass-Flörl C et al. Invasive candidiasis. Nat Rev Dis Primers. 2024 Mar 21. PMID: 38514673. doi: 10.1038/s41572-024-00503-3. PubMed: https://pubmed.ncbi.nlm.nih.gov/38514673/