{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T05:27:26Z","timestamp":1790400446280,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,10,18]],"date-time":"2022-10-18T00:00:00Z","timestamp":1666051200000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p><jats:italic>Candida auris<\/jats:italic> is an emerging nosocomial pathogen worldwide. However, there has been little published on the management of <jats:italic>C. auris<\/jats:italic> in solid organ transplant recipients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A single\u2010center, retrospective cohort study was conducted to evaluate <jats:italic>C. auris<\/jats:italic> bloodstream infections in solid organ transplant recipients between January 2020 and December 2021. Patient\u2010related and outcomes data were extracted from electronic medical records.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 42 patients identified with <jats:italic>C. auris<\/jats:italic> bloodstream infections, five were in solid organ transplant recipients (1 heart, 3 liver, and 1 combined liver\u2010kidney). The median time to fungemia from hospital admission was 43 days, and the median time to fungemia from transplant was 18 days. All patients received micafungin as initial treatment, at a median of 6 hours from pathogen detection. Four patients achieved blood clearance, two patients had persistent fungemia, and two patients developed secondary complications from hematogenous spread. One patient died, resulting in a mortality rate of 20%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Solid organ transplant recipients are at high risk for developing <jats:italic>C. auris<\/jats:italic> bloodstream infections. In order to prevent graft loss and mortality, best practices for the management of <jats:italic>C.auris<\/jats:italic> should include rapid screening, diagnosis, and treatment. While echinocandins are considered first\u2010line, antifungal selection should be based on susceptibilities and site of infection. Data to support routine use of combination therapy are lacking, however there may be a role for refractory cases. Prevention efforts against <jats:italic>C. auris<\/jats:italic> infection are especially important given the lack of effective decolonization strategies. For transplant recipients, hospitals should seek opportunities to restore patients' gut microbiome by curtailing unnecessary hospital procedures and inappropriate antimicrobial use. Further research and national guidelines are needed to better direct stewardship in this field.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.13919","type":"journal-article","created":{"date-parts":[[2022,10,18]],"date-time":"2022-10-18T07:04:42Z","timestamp":1666076682000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Challenges and opportunities in stewardship among solid organ transplant recipients with <i>Candida auris<\/i> bloodstream infections"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0162-5101","authenticated-orcid":false,"given":"Christine A.","family":"Vu","sequence":"first","affiliation":[{"name":"Department of Pharmacy Jackson Memorial Hospital  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Jimenez","sequence":"additional","affiliation":[{"name":"Department of Infection Prevention and Control Jackson Health System  Miami Florida USA"},{"name":"Department of Epidemiology, Robert Stempel College of Public Health and Social Work Florida International University  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7761-1163","authenticated-orcid":false,"given":"Shweta","family":"Anjan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Disease University of Miami Miller School of Medicine  Miami Florida USA"},{"name":"Miami Transplant Institute Jackson Health System  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1974-4547","authenticated-orcid":false,"given":"Lilian M.","family":"Abbo","sequence":"additional","affiliation":[{"name":"Department of Infection Prevention and Control Jackson Health System  Miami Florida USA"},{"name":"Department of Medicine, Division of Infectious Disease University of Miami Miller School of Medicine  Miami Florida USA"},{"name":"Miami Transplant Institute Jackson Health System  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,10,18]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Infection Prevention and Control forCandida auris.Centers for Disease Control and Prevention. Accessed July 16 2022.https:\/\/www.cdc.gov\/fungal\/candida\u2010auris\/c\u2010auris\u2010infection\u2010control.html"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofy210.1695"},{"issue":"3081","key":"e_1_2_9_4_1","first-page":"1","article-title":"C. auris: what have we learned about its mechanisms of pathogenicity","volume":"9","author":"Rossato L","year":"2018","journal-title":"Front Microbiol"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw691"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14121"},{"key":"e_1_2_9_7_1","unstructured":"Treatment and management of infections and colonization.Centers for Disease Control and Prevention. Accessed April 18 2022.https:\/\/www.cdc.gov\/fungal\/candida\u2010auris\/c\u2010auris\u2010treatment.html"},{"key":"e_1_2_9_8_1","unstructured":"Antifungal susceptibility testing and interpretation.Centers for Disease Control and Prevention. Accessed April 18 2022.https:\/\/www.cdc.gov\/fungal\/candida\u2010auris\/c\u2010auris\u2010antifungal.html"},{"key":"e_1_2_9_9_1","unstructured":"Healthcare\u2010associated infections (HAIs). Central line\u2010associated bloodstream infection (CLABSI).Centers for Disease Control and Prevention. Accessed April 18 2022.https:\/\/www.cdc.gov\/hai\/bsi\/bsi.html"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40121-022-00625-9"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2020.02.001"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S116229"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinmicnews.2017.06.003"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1086\/599376"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16144"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1086\/504810"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.7326\/M19-2205"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof7100878"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmni.2016.07.003"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6901a2"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.02031-20"},{"issue":"12","key":"e_1_2_9_22_1","first-page":"e01393","article-title":"In vitro antifungal combination of flucytosine with amphotericin B, voriconazole, or micafungin against Candia auris shows no antagonism","volume":"53","author":"Bidaud AL","year":"2019","journal-title":"Antimicrob Agents Chemother"},{"issue":"4","key":"e_1_2_9_23_1","first-page":"e02195","article-title":"In vitro evaluation of antifungal drug combinations against multidrug\u2010resistant Candida auris isolates from New York outbreak","volume":"64","author":"O'Brien B","year":"2020","journal-title":"Antimicrob Agents Chemother"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/mmy\/myac008"},{"key":"e_1_2_9_25_1","first-page":"6007607","article-title":"Candida auris invasive infection after kidney transplantation","volume":"2022","author":"Reque J","year":"2022","journal-title":"Case Rep Nephrol"}],"container-title":["Transplant Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.13919","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/tid.13919","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.13919","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T22:40:13Z","timestamp":1692571213000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tid.13919"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10]]},"references-count":24,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,10]]}},"alternative-id":["10.1111\/tid.13919"],"URL":"https:\/\/doi.org\/10.1111\/tid.13919","archive":["Portico"],"relation":{},"ISSN":["1398-2273","1399-3062"],"issn-type":[{"value":"1398-2273","type":"print"},{"value":"1399-3062","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10]]},"assertion":[{"value":"2022-04-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-17","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13919"}}