Analysis of Candida auris fungemia at a single facility in Kenya.

• Candida auris appeared and became the predominant Candida species in 2011. • C. auris candidemia is more associated with central venous catheterization than candidemia caused by Candida albicans. • C. auris is resistant in vitro to the azoles. • Even with drugs that are active in vitro, candidemia is difficult to clear. • C. auris candidemia patients are older and with prolonged hospitalization, but don't have increased mortality. Candida auris emerged as a human pathogen in 2009 and has subsequently been identified around the world as a cause of invasive candidiasis. We did an analysis from a single institution in order to analyze risk factors and outcomes for C. auris candidemia. Patients with candidemia were identified by the electronic medical record and reviewed for risk factors and outcome. Candida isolates were identified by Vitek2 as Candida haemulonii , but species determinations for 21 of the isolates using published molecular and proteomic methods identified all as C. auris. From September 2010 to December 2016, C. auris accounted for 38% of 201 patients with candidemia, while C. albicans contributed 25%. C. auris patients had been hospitalized longer (mean 32 days vs. 13 days; p < 0.001), were more likely to have central lines preceding candidemia than C. albicans patients (84% vs. 54%; p = < 0.001) and had more commonly been treated with carbapenems (83% vs 61% for C. albicans [p = 0.01]). The crude mortality was 29%, compared to 36% for C. albicans. These findings suggest an opportunistic pathogen that may be less virulent, but difficult to eradicate and that control efforts should focus on antimicrobial usage. [ABSTRACT FROM AUTHOR]