Candida auris in Intensive Care Setting: The First Case Reported in Portugal.

Candida auris is an opportunistic human pathogen that has rapidly spread to multiple countries and continents and has been associated with a high number of nosocomial outbreaks. Herein, we report the first case of C. auris in Portugal, which was associated with a patient transferred from Angola to an ICU in Portugal for liver transplantation after a SARS-CoV-2 infection. C. auris was isolated during the course of bronchoalveolar lavage, and it was subjected to antifungal susceptibility testing and whole-genome sequence analysis. This isolate presents low susceptibility to azoles and belongs to the genetic clade III with a phylogenetic placement close to African isolates. Although clade III has already been reported in Europe, taking into account the patient's clinical history, we cannot discard the possibility that the patient's colonization/infection occurred in Angola, prior to admission in the Portuguese hospital. Considering that C. auris is a fungal pathogen referenced by WHO as a critical priority, this case reinforces the need for continuous surveillance in a hospital setting.

Is the efficacy of remdesivir so different from that of lopinavir-ritonavir in severe COVID-19? The answer by real time-PCR: a narrative review.

This letter discusses the efficacy of current antiviral therapy used in severe COVID-19 infection. Since the first severe cases were documented, several antiviral options have been studied as adjuncts to standard supportive care [1, 2]. Firstly, the combination of lopinavir-ritonavir resurrected from SARS and MERS outbreaks and soon abandoned after the publication of several trials like the randomized controlled trial RECOVERY, which concluded that it was not associated with reductions in 28-day mortality, duration of hospital stay, or risk of progression to invasive mechanical ventilation or death [3]. Remdesivir is currently the only antiviral agent approved for the treatment of COVID-19. It is recommended for use in hospitalized patients who require supplemental oxygen. However, it is not routinely recommended for patients who require mechanical ventilation due to the lack of data showing any benefit at this advanced stage of the disease [4-6].