A Life-threatening Case Report of Candidemia in an Infant Hidden behind Multiple Co-morbidities Detected by MALDI-TOF

Background and purpose: Candida auris is an emerging species of the Candida genus causing outbreaks of nosocomial infections worldwide. It is a multidrug-resistant fungal pathogen causing disruption in healthcare settings as it quickly colonizes the surfaces in hospitals and ICUs and causes repeated infections. This report describes a case of C. auris fungemia from a tertiary care hospital in Central Delhi, India. Case report: Our patient is a 5-month-old male infant from the town of Allahabad, Northern India. Septic arthritis is treated by arthrotomy. Urinary Tract Infection (UTI) developed as a secondary complication due to suspected pyonephrosis or vesicoureteral reflux. The patient was treated with Caspofungin. In this report, Candida auris was identified using matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) and VITEK 2 (bioMérieux), from bloodstream infection in a patient with multiple underlying risk factors and COVID-19 positive. Candidemia was diagnosed with sepsis following prolonged hospitalization in spite of aggressive medical management. Conclusion: In conclusion, C. auris is a new multidrug-resistant pathogenic candida species, increasingly associated with nosocomial outbreaks and sporadic infections. This species is a concern for clinicians and microbiologists as they pose a major challenge during the management of the infection. The nosocomial spread can be controlled through proper disinfection, increasing awareness, early detection and appropriate anti-fungal susceptibility-guided treatment.