How to control candida auris infection of my mother?

Question

Hello, Doctor,

My 74-year-old mother was just diagnosed with Candida auris infection in her surgical wound following complex abdominal surgery 3 weeks ago. The hospital has suddenly implemented strict isolation protocols, and the medical team seems extremely concerned. Mom has multiple health issues—uncontrolled diabetes (A1C 10.6), heart failure with EF of 35%, and chronic kidney disease with GFR of 38. She's been in and out of the ICU since her surgery due to complications, and now this fungal infection has appeared. Her surgical wound has been draining purulent fluid for days, and they have cultured Candida auris from both the wound and her blood. Her fever has been ranging from 100.2 to 103.5 degrees Fahrenheit despite broad-spectrum antibiotics.

They have started her on an Echinocandin through her central line but mentioned the strain might be resistant to multiple antifungals. Her white count is 18.7, and she is becoming increasingly confused, which they say could be from the infection itself. The infectious disease doctor mentioned a mortality rate that terrified me - said patients with her combination of comorbidities and Candida auris bloodstream infections have poor outcomes. The hospital has implemented special cleaning protocols and limited visitors. Mom has a PICC (Peripherally inserted central catheter) line, urinary catheter, and feeding tube - all possible sources for fungal colonization. Given her age and multiple health problems, what are her chances of surviving this infection? The ICU doctor seemed extremely worried when discussing her prognosis with us. Is there anything else we should be asking for in terms of treatment? How long might she need to remain isolated, even if she recovers?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

I am sorry your mother is going through this. Here is a simpler breakdown of what is going on:

Chances of survival: Candida auris is serious, especially in people with health problems like diabetes, heart failure, and kidney disease. It is hard to predict, but her chances depend on how well the treatment works and how stable her other health issues are.
Treatment: They have started her on a strong antifungal medicine (Echinocandin), which is a good option. But some strains of Candida auris do not respond to medicines, so they might need to change her treatment if needed.
Other things to consider: Make sure the medical team is looking at all the possible places the infection could come from, like her feeding tube, catheter, and PICC (peripherally inserted central catheter) line. They may need to remove or replace them if they’re causing an infection.
Isolation: She needs to stay isolated to stop the infection from spreading to others. Even after she improves, she may need to stay isolated for a while, depending on how the infection responds.
Confusion: The confusion your mom is experiencing might be from the infection, medications, or other health problems. It’s important to keep track of how this changes and tell her doctors if you’re worried.

I hope this information helps you.

Feel free to ask further queries.

Thank you.