2075. First nine cases of Candida auris infection Reported in Central America: Importance of acurate diagnosis and susceptibility testing
Session: Poster Abstract Session: Diagnostics - Mycology
Saturday, October 7, 2017
Room: Poster Hall CD
Posters
  • Candida auris.pdf (2.3 MB)
  • Background: Candida auris is an emerging multidrug-resistant pathogen associated with invasive infections and high mortality. This report describes the first 9 cases of C. auris in Central America in a hospital in Panama City, Panama, and highlights the challenges of accurate identification and methods for susceptibility testing.

    Methods: Isolates initially identified at a Panama City acute care hospital during July–October 2016 as Candida haemulonii (a common misidentification for C. auris) or Candida species by Vitek® 2 automated system (bioMérieux) were further characterized by molecular methods. Antifungal susceptibility testing was performed and results were compared between standard and reference methodologies. Patient demographic, clinical, and laboratory data were collected from the medical record.

    Results: A total of 14 isolates from 9 hospitalized patients were confirmed as C. auris. Isolates were from urine (11), blood (1), catheter tip (1) and pleural fluid (1). Results of susceptibility testing were highly discrepant between automated and reference techniques for fluconazole (92% resistant vs. 77%, respectively) and amphotericin B (100% vs. 8%). Six (67%) patients were male, and the mean age was 53 years (range 42-78). All patients were admitted to the intensive care unit and were mechanically ventilated. Seven (78%) patients died.

    Conclusion: C. auris is present in Central America. Healthcare facilities in the region should be vigilant for this concerning pathogen, particularly given challenges in its identification and need for infection control precautions. Although automated testing overestimated amphotericin B resistance, most initial isolates were susceptible by reference testing.

    Ana Belen Arauz Rodriguez, MD1, Diego H. Caceres, MSc2,3, Erika Santiago, Microbiologist1, Paige Armstrong, MD MHS4, Amalia Rodriguez French, MD1, Susan Arosemena, MD1, Carolina Ramos, RN1, Andres Espinosa-Bode, MD5, Jovanna Borace, Microbiologist1, Lizbeth Hayer, MD6, Israel Cedeño, MD6, Nestor Sosa, MD7, Elizabeth L. Berkow, PhD2, Shawn R Lockhart, PhD2, Brendan R. Jackson, MD, MPH2 and Tom Chiller, MD, MPH2, (1)Hospital Santo Tomas, Panama City, Panama, (2)Centers for Disease Control and Prevention, Atlanta, GA, (3)Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN, (4)Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, GA, (5)Central American Region, Centers for Disease Control and Prevention, Guatemala, Guatemala, (6)Ministerio de Salud de Panama, Panama City, Panama, (7)Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama

    Disclosures:

    A. B. Arauz Rodriguez, None

    D. H. Caceres, None

    E. Santiago, None

    P. Armstrong, None

    A. Rodriguez French, None

    S. Arosemena, None

    C. Ramos, None

    A. Espinosa-Bode, None

    J. Borace, None

    L. Hayer, None

    I. Cedeño, None

    N. Sosa, None

    E. L. Berkow, None

    S. R. Lockhart, None

    B. R. Jackson, None

    T. Chiller, None

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