First Case of Candida auris Colonization in a Preterm, Extremely Low-Birth-Weight Newborn after Vaginal Delivery

Abstract

Candida auris is a multidrug-resistant, difficult-to-eradicate pathogen that can colonize patients and health-care environments and cause severe infections and nosocomial outbreaks, especially in intensive care units. We observed an extremely low-birth-weight (800 g), preterm neonate born from vaginal delivery from a C. auris colonized mother, who was colonized by C. auris within a few hours after birth. We could not discriminate whether the colonization route was the birth canal or the intensive care unit environment. The infant died on her third day of life because of complications related to prematurity, without signs or symptoms of infections. In contexts with high rates of C.auris colonization, antifungal prophylaxis in low-birth-weight, preterm neonates with micafungin should be considered over fluconazole due to the C. auris resistance profile, at least until its presence is excluded.

South Asian (Clade I) Candida auris meningitis in a paediatric patient in Iran with a review of the literature

“…Under this assumption, the patient might have been colonised with C auris during delivery from the C auris colonised mother or nosocomially in the hospital environment. Asymptomatic colonised patients with C auris on different body sites, that is, ear canal, axilla, groin, nares, oropharynx, urine, rectum and even vagina can be the source of nosocomial transmission within healthcare facilities 38 . Screening patients for C auris colonisation allows facilities to identify those with C auris colonisation and implement infection prevention and control measures 39 .…”

“…Asymptomatic colonised patients with C auris on different body sites, that is, ear canal, axilla, groin, nares, oropharynx, urine, rectum and even vagina can be the source of nosocomial transmission within healthcare facilities. 38 Screening patients for C auris colonisation allows facilities to identify those with C auris colonisation and implement infection prevention and control measures. 39 Notoriously, host to-host transmission as potential source of C auris colonisation in long-term care facilities is very commonly observed in the United States.…”

Navigating the New Reality: A Review of the Epidemiological, Clinical, and Microbiological Characteristics of Candida auris, with a Focus on Children

“…According to the European CDC survey, 10 European countries have encountered patients colonized or infected with C. auris [ 70 ]. At present, 256 pediatric incidences have been reported from Venezuela, Colombia, Pakistan, Republic of Korea, India, Oman, Iran, Italy and the Gauteng province in South Africa [ 16 , 17 , 20 , 21 , 22 , 23 , 24 , 25 , 29 , 30 , 31 , 32 , 34 , 48 ] ( Figure 1 ). The majority of pediatric incidences were reported from South America (114/256, 45%) and South Asia (67/256, 26%), in several nosocomial outbreaks.…”

“…In children, however, asymptomatic colonization was rarely described. Colonization was reported in a neonate born to a colonized mother; the skin (axilla), eyes and ears were involved [ 21 ]. Also, progression from colonization to infection was not clearly described.…”

“…Publications were reviewed and selected based on their quality and pertinence. Following exclusion of suspected repetitive studies, the search yielded 23 publications that reported C. auris incidents in children [ 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ]. Twelve publications included both adult and pediatric patients [ 17 , 19 , 20 , 23 , 24 , 26 , 27 , 28 , 32 , 35 , 36 , 37 ]; of them, one did not provide specific details of the pediatric patients and was excluded [ 26 ].…”