Isolation of Candida auris in surgical wound cultures as a probable cause for invasive spinal infection: a case report

C. auris is identified as an emerging multi-drug resistant fungal threat causing invasive infections and hospital outbreaks. C. auris effectively colonizes the skin, leading to invasive candidiasis by entering the bloodstream and/or the deeper tissues when there is a breach of the skin barrier, such as a surgical wound. The purpose of this report is to present a case of a possible C. auris spine infection through this mechanism.

A 73-year-old male who was diagnosed with spondylodiscitis following a multiple-level kyphoplasty-vertebroplasty was admitted to our department. The patient underwent surgical debridement and posterior stabilization. The only pathogen isolated was C. auris from surgical wound cultures postoperatively. Most likely, the patient was colonized by C. auris during his stay in the Intensive Care Unit (ICU), where he was transferred after vertebroplasty-kyphoplasty. His surgical wound could serve as a portal for C. auris entry into the deeper spinal tissues following skin colonization. The patient responded to the antifungal treatment administered following the surgical debridement. In the last follow-up, he was in good clinical condition, and the inflammatory markers levels were within normal limits.

Through this report, we aim to highlight the critical role of C. auris skin colonization in the pathogenesis of a localized deep-seated infection and to raise awareness of the possibility of a localized invasive infection due to C. auris by contiguous spread after an ICU hospitalization in patients who have undergone recent surgery.