Van Schalkwyk, ErikaMpembe, Ruth S.Thomas, JunoShuping, LiliweIsmail, HusnaLowman, WarrenKarstaedt, Alan S.Chibabhai, VindanaWadula, JeannetteAvenant, Theunis JohannesMessina, AngelikiGovind, Chetna N.Moodley, KrishneeDawood, HalimaRamjathan, PrakshaGovender, Nelesh P.2020-01-242020-01-242019Van Schalkwyk, E., Mpembe, R.S., Thomas, J. et al. 2019, 'Epidemiologic shift in Candidemia driven by Candida auris, South Africa, 2016–2017', Emerging Infectious Diseases, vol. 25, no. 9, pp. 1698-1707.1080-6040 (print)1080-6059 (online)10.3201/eid2509.190040http://hdl.handle.net/2263/72897Candida auris is an invasive healthcare-associated fungal pathogen. Cases of candidemia, defined as illness in patients with Candida cultured from blood, were detected through national laboratory-based surveillance in South Africa during 2016–2017. We identified viable isolates by using mass spectrometry and sequencing. Among 6,669 cases (5,876 with species identification) from 269 hospitals, 794 (14%) were caused by C. auris. The incidence risk for all candidemia at 133 hospitals was 83.8 (95% CI 81.2–86.4) cases/100,000 admissions. Prior systemic antifungal drug therapy was associated with a 40% increased adjusted odds of C. auris fungemia compared with bloodstream infection caused by other Candida species (adjusted odds ratio 1.4 [95% CI 0.8–2.3]). The crude in-hospital case-fatality ratio did not differ between Candida species and was 45% for C. auris candidemia, compared with 43% for non–C. auris candidemia. C. auris has caused a major epidemiologic shift in candidemia in South Africa.en© 2019, Centers for Disease Control and Prevention (CDC)Candida aurisPatientsFungal pathogenCandidemiaSouth Africa (SA)Article