Low Colonisation Rate of Candida auris in Patients of Intensive Care Units: A Study From Central India

TL;DR

This study found a low rate of Candida auris colonization in ICU patients in central India, but noted higher Candida colonization in those receiving certain antibiotics.

Contribution

The study provides new data on C. auris colonization rates in a central Indian ICU setting and identifies antibiotic associations with Candida colonization.

Findings

Only 5.55% of Candida isolates were identified as C. auris among ICU patients.

Candida colonization was more common in patients receiving meropenem and amoxicillin-clavulanate.

Other Candida species, such as C. glabrata and C. parapsilosis, were more frequently isolated.

Abstract

Introduction

Invasive candidiasis is associated with increased morbidity and mortality in critically ill patients. Candida auris (C. auris) is a growing concern in healthcare settings, especially in intensive care units (ICUs), due to its rapid spread, limited treatment options, and high mortality risk, posing a substantial challenge for physicians. In this study, we aimed to estimate the prevalence of C. auris colonization in patients admitted to ICUs of a tertiary care centre in central India.

Methods

A composite swab from the axilla and groin of patients at the time of admission and one week after admission was collected and subjected to culture and identification by conventional methods and using the Vitek 2 Yeast Identification System. Data from the case record forms were compiled in an Excel sheet (Microsoft® Corp., Redmond, WA) and analysed. Descriptive statistics, including frequency, mean, and standard deviation, were calculated for the demographic data. All statistical analyses were performed using Epi Info (version 7.2.5.0; Centers for Disease Control and Prevention, Atlanta, GA).

Results

Out of the 67 patients enrolled in the study, follow-up samples after one week of admission were only possible for 37 of the patients. Overall, a total of 18 Candida isolates were obtained from 67 patients, out of which, only one isolate (5.55%) was identified as C. auris. Other species of Candida were Candida glabrata (13), Candida parapsilosis (three), and Candida tropicalis (one). Candida colonisation was seen more in patients on meropenem and amoxicillin-clavulanate acid (p=0.02).

Conclusion

The low detection rate of C. auris colonisation among ICU patients in this study suggests limited spread within the facility during the study period. However, the overall Candida colonisation, particularly among patients receiving broad-spectrum antibiotics, highlights the importance of antimicrobial stewardship and active surveillance.