Rezafungin for Sternal Wound Infection Caused by Multidrug-Resistant Candidozyma auris: A Case Report

​ABSTRACT  Introduction  Candidozyma auris is an emerging multidrug-resistant fungal pathogen associated with healthcare outbreaks and significant mortality. Management can be challenging due to antifungal resistance and the need for prolonged intravenous therapy.  Case Presentation  A 58-year-old man developed a postoperative sternal wound infection caused by multidrug-resistant Candidozyma auris following aortic valve replacement, coronary artery bypass grafting and ascending aortic interposition graft surgery. His postoperative course was complicated by Staphylococcus epidermidis prosthetic graft infection requiring redo valve replacement and graft repair and placement of Vacuum assisted closure (VAC).  Two weeks after discharge home, persistent wound discharge yielded Candidozyma auris. Following surgical debridement and initiation of intravenous caspofungin with oral itraconazole, once daily intravenous antifungal therapy was transitioned to once-weekly intravenous rezafungin to facilitate outpatient treatment coordinated with vacuum-assisted wound therapy.  Conclusion  After twelve weeks of dual antifungal therapy complete clinical and microbiological resolution was achieved without adverse events. This case highlights the feasibility of rezafungin as an outpatient treatment strategy for complex multidrug-resistant Candidozyma auris infections.