A donor-derived Candida auris candidemia following a liver transplantation for colorectal liver metastases

BACKGROUND AND PURPOSE: Invasive fungal infections (IFIs) remain a major complication after solid organ transplantation (SOT). Candida auris (C. auris) is an emerging pathogen of particular concern because of its multidrug resistance, diagnostic challenges, and propensity for nosocomial transmission. We report a case of donor-derived C. auris candidemia identified shortly after deceased donor liver transplantation. CASE REPORT: A 43-year-old woman diagnosed with progressive colorectal cancer and hepatic metastases underwent a liver transplantation from a deceased donor. Her surgical procedure was uneventful. However, blood cultures obtained within 24 hours post-transplant revealed the presence of C. auris. Retrospective culture of the donor's stored blood confirmed the same organism. The patient received 14-day regimen of intravenous micafungin following initial empirical echinocandin therapy and experienced an uncomplicated recovery, exhibiting no signs of disseminated infection. CONCLUSION: Donor-derived C. auris infection in SOT recipients is uncommon yet potentially life-threatening. The early detection, prompt antifungal therapy guided by susceptibility testing, and coordinated infection control measures are imperative to mitigate morbidity and curtail transmission.