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Cited by 357Antifungal resistance and susceptibilityYeasts and Rust Fungi StudiesOcular Infections and Treatments

Candida auris candidaemia in Indian ICUs: analysis of risk factors

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Rudramurthy, Shivaprakash M., Chakrabarti, Arunaloke, Paul, Raees A., Sood, Prashant, Kaur, Harsimran, Capoor, Malini R., Kindo, Anupma J., Marak, Rungmei S. K. +9 more·2017·Journal of Antimicrobial Chemotherapy
DOI 10.1093/jac/dkx034
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Abstract

Objectives: To identify the risk factors associated with Candida auris candidaemia, as this fungus now poses a global threat. Methods: We performed a subgroup analysis of a previously reported study of 27 Indian ICUs. The clinical data of candidaemia cases due to C. auris and other Candida species were compared to determine significant risk factors associated with C. auris infection. Results: Of the 1400 candidaemia cases reported earlier, 74 (5.3%) from 19 of 27 ICUs were due to C. auris . The duration of ICU stay prior to candidaemia diagnosis was significantly longer in patients with C. auris candidaemia (median 25, IQR 12-45 days) compared with the non- auris group (median 15, IQR 9-28, P < 0.001). Based on logistic regression modelling, admission to north Indian ICUs [OR 2.1 (1.2-3.8); P = 0.012], public-sector hospital [OR 2.2 (1.2-3.9); P = 0.006], underlying respiratory illness [OR 2.1 (1.3-3.6); P = 0.002], vascular surgery [OR 2.3 (1.00-5.36); P = 0.048], prior antifungal exposure [OR 2.8 (1.6-4.8); P < 0.001] and low APACHE II score [OR 0.8 (0.8-0.9); P = 0.007] were significantly associated with C. auris candidaemia. The majority (45/51, 88.2%) of the isolates were clonal. A considerable number of isolates were resistant to fluconazole ( n = 43, 58.1%), amphotericin B ( n = 10, 13.5%) and caspofungin ( n = 7, 9.5%). Conclusions: Although C. auris infection has been observed across India, the number of cases is higher in public-sector hospitals in the north of the country. Longer stay in ICU, underlying respiratory illness, vascular surgery, medical intervention and antifungal exposure are the major risk factors for acquiring C. auris infection even among patients showing lower levels of morbidity.

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Crossref · 10.1093/jac/dkx034

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  • Prior use of antifungals such as fluconazole has been associated with an increased risk for C. auris skin colonization and infection, representing 11.7% of the cases and 65.2% of the invasive infections in humans.

    “Prior use of antifungals such as fluconazole has been associated with an increased risk for C. auris skin colonization and infection, which represented 11.7% of the cases [45] and 65.2% of the invasive infections in humans [53].”

    From Host–Candida auris interactions in the skin (2026) · cites this paper as [53]

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Authors
Rudramurthy, S. M., Chakrabarti, A., Paul, R. A., Sood, P., Kaur, H., Capoor, M. R., Kindo, A. J., Marak, R. S. K., Arora, A., Sardana, R., Das, S., Chhina, D., Patel, A., Xess, I., Tarai, B., Singh, P., & Ghosh, A.
Affiliations
  • Post Graduate Institute of Medical Education and Research (IN)
  • Vardhman Mahavir Medical College & Safdarjung Hospital (IN)
  • Sri Ramachandra Institute of Higher Education and Research (IN)
  • Sanjay Gandhi Post Graduate Institute of Medical Sciences (IN)
  • Fortis Escorts Heart Institute (IN)
  • Indraprastha Apollo Hospitals (IN)
  • University of Delhi (IN)
  • Dayanand Medical College & Hospital (IN)
  • Sterling Hospitals (IN)
  • All India Institute of Medical Sciences (IN)
  • Max Healthcare (IN)
Corresponding author
Chakrabarti, Arunaloke
ORCID
Venue
Journal of Antimicrobial Chemotherapy
Publisher
Oxford University Press (OUP)
Published
2017-02-20
Volume
72
Issue
6
Pages
1794-1801
ISSN
  • 0305-7453 (ISSN-L)
  • 1460-2091
DOI
10.1093/jac/dkx034
OpenAlex
W2591349562
Cited by
357
References
1
Citations by year
2026: 30 · 2025: 44 · 2024: 34 · 2023: 24 · 2022: 43 · 2021: 38 · 2020: 48 · 2019: 45 · 2018: 25 · 2017: 24
FWCI
30.04
Type
journal article
Language
en
Open access
Locations
  • Journal of Antimicrobial Chemotherapy (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Kasturba Medical College, Manipal
  • Jawaharlal Institute Of Postgraduate Medical Education and Research
  • Centers for Disease Control and Prevention
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Yeasts and Rust Fungi Studies
  • Health Sciences › Medicine › Ophthalmology › Ocular Infections and Treatments
Keywords
Candida auris, candidemia, risk factors, intensive care unit, antifungal resistance, fluconazole resistance, clonal isolates, vascular surgery, respiratory diseases, APACHE II score, public hospitals, North India, hospital-acquired fungal infection, caspofungin resistance, amphotericin B resistance, ICU length of stay
MeSH terms
Caspofungin, Adolescent, Adult, Aged, Amphotericin B, Antifungal Agents, Candida, Female, Humans, India, Intensive Care Units, Male, Microbial Sensitivity Tests, Middle Aged, Risk Factors, Fluconazole, Mycological Typing Techniques, Echinocandins, Lipopeptides, Young Adult, Candidemia

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