A multicenter study has shed light on various factors that contribute to increased mortality among patients suffering from Candida auris bloodstream infection (BSI). The research, published in Clinical Infectious Diseases, suggests that a one-point rise in the Pitt bacteremia score (used to gauge the seriousness of a patient’s acute illness) at the onset of C. auris BSI could lead to 19% higher odds of death. Additionally, patients undergoing hemodialysis were found to be thrice as likely to succumb to the infection.
Since its identification just 15 years ago, the multidrug-resistant C. auris has increasingly caused nosocomial outbreaks, with a conspicuous ability to spread rapidly within hospitals, especially in the United States. The novel exploratory study employed the expertise of Dr. Adriana Jimenez, an infection prevention manager at the University of Miami Health System, among others. The team retrospectively gathered and analyzed clinical data from adult C. auris patients in South Florida and Southern California academic health systems and a county health department from September 2017 to December 2022.
This data encompassed various patient facets such as demographics, medical comorbidities, antifungal susceptibilities, histories of antibiotic and antifungal administration, potential infectious sources, severity of illness as indicated by the Pitt bacteremia score, and clinical outcomes. Although the Pitt bacteremia score has been validated in earlier studies to evaluate severity of illness in non-C. auris Candida BSIs, this study is first of its kind to use the score to prognosticate mortality in C. auris BSI cases.
The study found that over half, or 54.6%, of patients, unfortunately, lost their lives. The analytical efforts of Dr. Jimenez and her team specifically point to a higher Pitt bacteremia score and patients being on hemodialysis as constituents leading to higher mortality rates in those suffering from C. auris BSI. Moreover, they discovered that the process of hemodialysis reduced the probability of a patient clearing their infection.
While the results are significant, they should be contextualized given the multitude of preexisting comorbidities amongst the patients, denoting a generally unwell demographic. As C. auris continues to spread, the researchers underscore the necessity to fathom risk factors that lead to unfavorable clinical outcomes, in the hope of modifying them through targeted prevention practices.
The team suggests that prioritizing infection prevention and control measures amongst vulnerable populations, like those dependent on hemodialia and having high Pitt bacteremia scores, could mitigate healthcare-associated fungemia and overall mortality.