Clinical Practice Recommendations for the Treatment of Candida auris Infection in Korea.

Abstract

Candida auris is an emerging multidrug-resistant fungal pathogen associated with invasive infections and high mortality. In Korea, C. auris infections have historically been caused predominantly by Clade II isolates; however, recent reports of invasive infections due to Clade I indicate an evolving epidemiology with potential implications for antifungal resistance and treatment strategies. To provide practical guidance for clinicians, we developed evidence-based recommendations for the management of C. auris infections in Korea through review of current international guidelines and available epidemiologic and clinical data, with multidisciplinary expert consensus. Antifungal therapy is not recommended for asymptomatic colonization. Echinocandins are recommended as first-line therapy for suspected or confirmed invasive C. auris infection, whereas amphotericin B deoxycholate is preferred for neonates and young infants. Antifungal susceptibility testing should be performed whenever invasive infection is suspected, although initiation of empirical therapy should not be delayed while awaiting results. Treatment should be reassessed according to susceptibility results, infection sites, and clinical response, with specialist consultation for refractory or complicated infections. These recommendations are based on the currently available evidence and epidemiology, warranting continued surveillance of epidemiologic changes and emerging clinical data.