Background Candida auris has become a growing concern worldwide because of increases in incidence of colonization and reports of invasive infections. There are limited data on clinical factors associated with poor outcomes in patients with C. auris bloodstream infection (BSI). Methods We assembled a multicenter retrospective cohort of patients with C. auris BSI from 2 geographics areas in US healthcare settings. We collected data on demographic, clinical, and microbiologic characteristics to describe the cohort and constructed multivariate logistic regression models to understand risk factors for 2 clinical outcomes, all-cause mortality during facility admission, and blood culture clearance. Results Our cohort consisted of 187 patients with C. auris BSI (56.1% male, 55.6% age >65 years); 54.6% died by facility discharge and 66.9% (of 142 with available data) experienced blood culture clearance. Pitt bacteremia score at infection onset was associated with mortality (odds ratio [95% confidence interval]: 1.19 [1.01–1.40] per 1-point increase). Hemodialysis was associated with a reduced odds of microbiologic clearance (0.15 [0.05–0.43]) and with mortality (3.08 [1.27–7.50]). Conclusions The Pitt bacteremia score at the onset of C. auris BSI may be a useful tool in identifying patients at risk for mortality. Targeted infection prevention practices in patients receiving hemodialysis may be useful to limit poor outcomes.

中文翻译：

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与耳念珠菌血流感染临床和微生物学结局不良相关的因素：一项多中心回顾性队列研究


背景 由于定植发生率的增加和侵袭性感染的报道，耳念珠菌在世界范围内已成为一个日益受到关注的问题。关于与耳念珠菌血流感染 （BSI） 患者不良结局相关的临床因素的数据有限。方法 我们收集了来自美国医疗机构 2 个地理区域的耳念珠菌 BSI 患者的多中心回顾性队列。我们收集了有关人口学、临床和微生物学特征的数据来描述队列，并构建了多变量 logistic 回归模型，以了解 2 种临床结局的危险因素、设施入院期间的全因死亡率和血培养清除率。结果 我们的队列由 187 例耳念珠菌 BSI 患者组成 （56.1% 为男性，55.6% 年龄 >65 岁）;54.6% 死于设施出院，66.9% （有可用数据的 142 例） 经历血培养清除。感染开始时的 Pitt 菌血症评分与死亡率相关 （比值比 [95% 置信区间]：每增加 1 分 1.19 [1.01–1.40]）。血液透析与微生物清除率降低 （0.15 [0.05–0.43]） 和死亡率 （3.08 [1.27–7.50]） 相关。结论 耳念珠菌 BSI 发作时的 Pitt 菌血症评分可能是识别有死亡风险患者的有用工具。对接受血液透析的患者进行有针对性的感染预防实践可能有助于限制不良结局。