Outbreak of Candida auris in Patients Infected with SARS-CoV-2 Experience in a Tertiary Care Center in Colombia

During the SARS-CoV-2 pandemic, healthcare systems faced an increased burden of secondary infections, including those caused by Candida auris, an emerging multidrug-resistant pathogen associated with hospital outbreaks worldwide. We aimed to describe the clinical and microbiological characteristics of a hospital outbreak of Candida auris fungemia in patients with COVID-19 in a tertiary care center. This retrospective observational study included 14 patients diagnosed between November 2020 and April 2021. Infection was initially identified using VITEK2® and confirmed using MALDI-TOF MS, with antifungal susceptibility determined using broth microdilution. All patients developed fungemia, were mechanically ventilated, and had central venous access and prolonged hospital stays; 64.2% had comorbidities. Resistance frequencies based on CDC tentative MIC thresholds were observed for fluconazole (64.2%) and amphotericin B (71.4%). In-hospital mortality was 50%; exploratory analyses of factors associated with mortality should be interpreted cautiously given the small sample size. These findings highlight the significant clinical impact of Candida auris in critically ill COVID-19 patients, particularly in the context of invasive care and antimicrobial resistance. The outbreak underscores the importance of early identification, appropriate antifungal therapy, and strict infection prevention and control measures. Further studies are needed to better define risk factors and optimize management strategies in similar settings.