Volume 29, Number 7—July 2023
Synopsis
Nationwide Outbreak of Candida auris Infections Driven by COVID-19 Hospitalizations, Israel, 2021–20221
Roni Biran, Regev Cohen, Talya Finn, Tal Brosh-Nissimov, Galia Rahav, Dafna Yahav, Sharon Amit, Yael Shachor-Meyouhas, Alaa Atamna, Jihad Bishara, Liat Ashkenazi-Hoffnung, Haim Ben Zvi, Mirit Hershman-Sarafov, Shlomo Maayan, Yasmin Maor, Orna Schwartz, Oren Zimhony, Jonathan Lellouche, Meital Elbaz, Ela Burdelova, Naama Mizrahi, Anna Novikov, Oryan Henig, and Ronen Ben-Ami
Table
Clinical characteristics of patients infected or colonized with Candida auris, Israel
| Characteristic | COVID-19 | Non–COVID-19 | p value | Total |
|---|---|---|---|---|
| No. patients |
41 (23.2) |
136 (76.8) |
177 (100) |
|
| Median age, y (IQR) |
67 (53–75) |
72 (56–82) |
0.16 |
70 (55–80) |
| Sex | ||||
| M | 24 (58.5) | 97 (71.3) | 0.13 | 121 (68.3) |
| F |
17 (41.4) |
39 (28.6) |
56 (31.6) |
|
| Long-term care facility |
5 (12.1) |
33 (24.2) |
0.12 |
38 (21.5) |
| Functional status | 0.0036 | |||
| Independent | 30 (73.1) | 59 (43.3) | 89 (50.3) | |
| Requires assistance | 4 (9.7) | 21 (15.4) | 25 (14.1) | |
| Complete dependence |
7 (17.0) |
56 (41.1) |
63 (35.6) |
|
| Comorbidities | ||||
| Dementia | 6 (14.6) | 46 (33.8) | 0.019 | 52 (29.4) |
| Malignancy | 3 (7.3) | 18 (13.2) | 0.41 | 21 (11.8) |
| Median Charlson comorbidity score (IQR) |
2 (0–3) |
3 (1–4) |
0.00016 |
2 (1–4) |
| Drug-resistant organism carriage/infection | ||||
| Any | 21 (51.2) | 76 (55.8) | 0.72 | 97 (54.8) |
| Vancomycin-resistant Enterococcus | 5 (12.1) | 17 (12.5) | 1.0 | 22 (12.4) |
| Methicillin-resistant Staphylococcus aureus | 10 (24.3) | 25 (18.3) | 0.38 | 35 (19.8) |
| Carbapenem-resistant Enterobacteriaceae | 8 (19.5) | 31 (22.7) | 0.83 | 39 (22.0) |
| Clostridioides difficile |
0 |
6 (4.4) |
0.33 |
6 (3.4) |
| Exposure to antimicrobials | ||||
| Antibacterial | 37 (90.2) | 119 (87.5) | 0.78 | 156 (88.1) |
| Azole | 5 (12.1) | 11 (8.0) | 0.53 | 16 (9.0) |
| Echinocandin | 2 (4.8) | 3 (2.2) | 0.32 | 5 (2.8) |
| Amphotericin B |
0 |
0 |
1.0 |
0 |
| COVID-19 severity and treatment | ||||
| Critical | 30 (73.1) | NA | 30 (76.9) | |
| Severe | 8 (19.5) | NA | 8 (20.5) | |
| Mild | 1 (2.4) | NA | 1 (2.5) | |
| Corticosteroids | 38 (97.4) | NA | 38 (97.4) | |
| Remdesivir |
17 (43.5) |
NA |
17 (43.5) |
|
| Treatment required | ||||
| Intensive care unit | 14 (34.1) | 34 (25.0) | 0.31 | 48 (27.1) |
| Mechanical ventilation | 32 (78.0) | 106 (77.9) | 1.0 | 138 (78.0) |
| Central venous catheter |
30 (73.1) |
89 (65.4) |
0.44 |
119 (67.2) |
| Outcome | ||||
| Median hospital stay, d (IQR) | 36 (24–52) | 36 (21–54) | 0.98 | 36 (21.5–54) |
| Median ICU stay, d (IQR) | 24 (18.5–38) | 21 (11.2–28.8) | 0.08 | 21.5 (13–33) |
| Median mechanical ventilation duration, d (IQR) | 35.5 (19.8–46) | 35 (17.8–51.2) | 0.60 | 35 (18–50) |
| In-hospital death | 15 (36.5) | 55 (40.4) | 0.71 | 70 (40.0) |
*Values are no. (% within COVID-19 group) except as indicated. IQR, interquartile range; NA, not applicable.
1Preliminary results from this study were presented at the 32nd European Congress of Clinical Microbiology and Infectious Diseases, April 23–26, 2022, Lisbon, Portugal.
Page created: April 29, 2023
Page updated: June 20, 2023
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