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Volume 25, Number 7—July 2019
CME ACTIVITY - Research

Hospital-Associated Multicenter Outbreak of Emerging Fungus Candida auris, Colombia, 2016

Paige A. Armstrong1Comments to Author , Sandra M. Rivera1Comments to Author , Patricia Escandon, Diego H. Caceres, Nancy Chow, Matthew J. Stuckey, Jorge Díaz, Adriana Gomez, Norida Vélez, Andres Espinosa-Bode, Soraya Salcedo, Adriana Marin, Indira Berrio, Carmen Varón, Angel Guzman, Jairo E. Pérez-Franco, Julian D. Escobar, Nohora Villalobos, Juan M. Correa, Anastasia P. Litvintseva, Shawn R. Lockhart, Ryan Fagan, Tom M. Chiller, Brendan Jackson2, and Oscar Pacheco2
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P.A. Armstrong, D.H. Caceres, N. Chow, M.J. Stuckey, A. Espinosa-Bode, A.P. Litvintseva, S.R. Lockhart, R. Fagan, T.M. Chiller, B. Jackson); Instituto Nacional de Salud, Bogotá, Colombia (S.M. Rivera, P. Escandon, J. Díaz, A. Gomez, N. Vélez, O. Pacheco); Clínica General del Norte, Barranquilla, Colombia (S. Salcedo, A. Marin); Clínica El Rosario, Medellín, Colombia (I. Berrio); Corporación para Investigaciones Biológicas (CIB), Medellín (I. Berrio); Hospital General de Medellín, Medellín (I. Berrio); Hospital Doña Pilar, Cartagena, Colombia (C. Varón, A. Guzman); Hospital Militar Central, Bogotá (J.E. Pérez-Franco, J.D. Escobar); Clínica los Nogales, Bogotá (N. Villalobos, J.M. Correa)

Main Article

Table 3

Characteristics of patients who died at 30 d compared with those who survived Candida auris bloodstream infection, Colombia, 2015–2016*

Characteristic Total Died Survived Crude odds ratio (95% CI) p value†
All
 40 (100)
 17 (43)
 23 (58)
 NA
 NA
Age, y 0.18
<1 12 (30) 5 (29) 7 (30) 0.95 (0.24–3.75) 0.94
1–17 8 (20) 2 (12) 6 (26) 0.24 (0.04–1.45) 0.12
18–65 14 35) 5 (29) 9 (39) 0.65 (0.17–2.47) 0.53
>65
 6 (15)
 5 (29)
 1 (4)
 9.17 (0.96–87.79)
 0.05
Sex 0.92 (0.26–3.30) 0.9
M 24 (60) 10 (59) 14 (61)
F
 16 (40)
 7 (41)
 9 (39)
Concurrent conditions 35 (88) 16 (94) 19 (83) 3.37 (0.34–33.26) 0.30
Chronic renal disease 9 (23) 3 (18) 6 (26) 0.61 (0.13–2.88) 0.53
Hemodialysis dependent 9 (23) 3 (18) 6 (26) 0.61 (0.13–2.88) 0.53
Diabetes 7 (18) 6 (35) 1 (4) 12 (1.28–112.42) 0.03
Immunosuppressive condition
 6 (16)
 4 (24)
 2 (9)
 3.23 (0.52–20.20)
 0.21
Prematurity, n = 12
 5 (42)
 1 (6)
 4 (17)
 0.30 (0.03–2.93)
 0.30
Median length of hospital stay, d (IQR)
 46 (34–69)
 36 (29–45)
 63 (45–95)
 NA
 <0.01
Median length of ICU stay, d (IQR) 36 (25–58) 32 (27–44) 51 (14–76) NA 0.3
Central venous catheter 40 (100) 17 (100) 23(100) NA NA
Respiratory support 36 (90) 17 (100) 19 (83) NA 0.12
Vasopressors 31 (82) 16 (94) 15 (65) 8.53 (0.95–76.63) 0.06
Surgical procedure 28 (70) 13 (76) 15 (65) 1.73 (0.43–7.11) 0.45
Total parenteral nutrition 19 (50) 7 (41) 12 (52) 0.64 (0.18–2.28) 0.49
Corticosteroids 18 (47) 8 (47) 10 (43) 1.16 (0.33–4.07) 0.82
Hemodialysis 15 (38) 8 (47) 7 (30) 2.03 (0.55–7.47) 0.29
Chemotherapy
 4 (11)
 2 (12)
 2 (9)
 1.4 (0.18–11.08)
 0.74
Median time from admission to C. auris positive culture, d (IQR)
 22 (18–31)
 22 (21–37)
 21 (12–28)
 NA
 0.23
Isolates resistant to fluconazole, n = 34 6 (18) 4 (24) 2 (9) 3.23 (0.52–20.2) 0.21
Isolates resistant to amphotericin B, n = 34 10 (29) 4 (24) 6 (26) 0.87 (0.20–3.74) 0.85

*Values are no. (%) patients except as indicated. ICU, intensive care unit; IQR, interquartile ratio; NA, not applicable.
†Fisher exact test, χ2, t-test, or Wilcoxon rank as appropriate.

Main Article

1These authors contributed equally to this article.

2These authors contributed equally to this article.

Page created: June 13, 2019
Page updated: June 13, 2019
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