Abstract
Background Candida auris has emerged as an important healthcare-associated pathogen that has high mortality rates. Additionally, this pathogen can cause nosocomial outbreaks. However, in comparison to the vast majority of the pathogenic species from the genus Candida, C. auris is difficult to treat and identify by using conventional therapeutic and diagnostic modalities. The exact prevalence of this pathogen is largely unclear from Indian healthcare setups. This study aimed to determine the prevalence of C. auris in a tertiary care academic hospital in western Maharashtra and to study the associated risk factors of patients with C. auris infection. Methods Candida isolates were identified using conventional methods, including the germ tube test and colony morphology assessment on HiChrom™ Candida differential agar (Hi Media, Thane, India). Species-level identification was performed with the VITEK 2 system (version 8.01, BioMérieux, Marcy-l'Étoile, France), and Candida auris was confirmed using Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF-MS). Patient records were retrieved from patient files and reviewed retrospectively for demographic variables, risk factors, clinical conditions, treatment, and outcome. Results C. auris was isolated from nine clinical specimens. The prevalence of C. auris was 9.4% among non-albicans Candida species (n=96), whereas the prevalence of C. auris among total Candida isolates (n=147) was noted to be 6.1%. Multiple hospitalizations, ICU stay, comorbidities like chronic kidney disease, diabetes mellitus and hypertension along with concomitant bacterial infection and broad-spectrum antimicrobial therapy were associated risk factors. Conclusion In this study, C. auris was most predominantly isolated from urine specimens. The urinary tract infection (UTI) should not be ignored as at times it may progress to disseminated infection, especially in patients with comorbidities. The current study underlines the importance of automated systems for identifying C. auris. Prompt identification will aid in treatment whereas the implementation of infection prevention and control measures will help in the containment of infection spread in a healthcare setup.