scholarly journals Rapid genome sequencing for outbreak analysis of the emerging human fungal pathogen Candida auris

2017 ◽  
Author(s):  
Johanna Rhodes ◽  
Alireza Abdolrasouli ◽  
Rhys A. Farrer ◽  
Christina A. Cuomo ◽  
David M. Aanensen ◽  
...  
Keyword(s):  
Control Measures ◽  
Phylogenomic Analysis ◽  
Candida Auris ◽  
Human Fungal Pathogen ◽  
Episodic Selection ◽  
Oxford Nanopore ◽  
Invasive Infections ◽  
Spatiotemporal Clustering ◽  
Heterogenous Population ◽  
The Uk

AbstractBackgroundCandida auris was first described in 2009, and has since caused nosocomial outbreaks, invasive infections and fungaemia across 11 countries in five continents. An outbreak of C. auris occurred in a specialised cardiothoracic London hospital between April 2015 and November 2016, which to date has been the largest outbreak reported worldwide, involving a total of 72 patients.MethodsTo understand the epidemiology of C. auris infection within this hospital, we sequenced the genomes of outbreak isolates using Oxford Nanopore Technologies and Illumina in order to type antifungal resistance alleles and to explore the outbreak within its local and global context.FindingsPhylogenomic analysis placed the UK outbreak in the India/Pakistan clade, demonstrating an Asian origin. The outbreak showed similar diversity to that of the entire clade and limited local spatiotemporal clustering was observed. One isolate displayed resistance to both echinocandins and 5-flucytosine; the former was associated with a serine to tyrosine amino acid substitution in the gene FKS1, and the latter was associated with a phenylalanine to isoleucine substitution in the gene FUR1. These mutations are novel for this pathogen.InterpretationMultiple differential episodic selection of antifungal resistant genotypes has occurred within a genetically heterogenous population across this outbreak, creating a resilient pathogen and making it difficult to define local-scale patterns of transmission as well as implementing outbreak control measures.FundingAntimicrobial Research Collaborative, Imperial College London

scholarly journals Genomic epidemiology of the UK outbreak of the emerging human fungal pathogen Candida auris

2018 ◽  
Vol 7 (1) ◽  
pp. 1-12 ◽  
Author(s):  
Johanna Rhodes ◽  
Alireza Abdolrasouli ◽  
Rhys A. Farrer ◽  
Christina A. Cuomo ◽  
David M. Aanensen ◽  
...  
Keyword(s):  
Fungal Pathogen ◽  
Candida Auris ◽  
Genomic Epidemiology ◽  
Human Fungal Pathogen ◽  
The Uk

scholarly journals Author Correction: Genomic epidemiology of the UK outbreak of the emerging human fungal pathogen Candida auris

2018 ◽  
Vol 7 (1) ◽  
pp. 1-2 ◽  
Author(s):  
Johanna Rhodes ◽  
Alireza Abdolrasouli ◽  
Rhys A. Farrer ◽  
Christina A. Cuomo ◽  
David M. Aanensen ◽  
...  
Keyword(s):  
Fungal Pathogen ◽  
Candida Auris ◽  
Genomic Epidemiology ◽  
Human Fungal Pathogen ◽  
The Uk

scholarly journals Candida auris: Emergência Recente de um Fungo Patogénico Multirresistente

2020 ◽  
Vol 33 (10) ◽  
pp. 680
Author(s):  
Francisco Antunes ◽  
Cristina Veríssimo ◽  
Álvaro Ayres Pereira ◽  
Raquel Sabino
Keyword(s):  
Mortality Rates ◽  
Fungal Species ◽  
Species Level ◽  
Control Measures ◽  
Hospital Environment ◽  
Candida Auris ◽  
Infection Control Measures ◽  
The United Kingdom ◽  
Invasive Infections ◽  
A New Species

Candida auris was first described as a new species back in 2009. Although it differs markedly from other Candida species, this species can be misidentified as other yeasts in the routine microbiology laboratories. Therefore, its identification to species level should be confirmed by reference laboratories. Candida auris exhibits potential to cause invasive infections, and frequently shows a multidrugresistance pattern, and it is associated with high mortality rates. Outbreaks caused by Candida auris and associated with health care institutions have been reported in several countries around the world, including some European countries, such as the United Kingdom and Spain. In Portugal, to our knowledge, there are no known infections or colonization cases caused by Candida auris. This species can survive in the environment for several weeks and once introduced into the hospital environment, the risk of transmission is high, requiring strict infection control measures in order to prevent transmission. This paper intends to raise the awareness of the emergence of this fungal species, as well as to discuss the consequences of this situation.

Candida auris and Nosocomial Infection

2020 ◽  
Vol 21 (4) ◽  
pp. 365-373 ◽  
Author(s):  
Sweety Dahiya ◽  
Anil K. Chhillar ◽  
Namita Sharma ◽  
Pooja Choudhary ◽  
Aruna Punia ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Pathogenic Fungus ◽  
Control Measures ◽  
Whole Genome Sequence ◽  
Whole Genome ◽  
Drug Resistant ◽  
Candida Auris ◽  
Preventive Control ◽  
Identification Techniques ◽  
Sensitivity Profile

The existence of the multi-drug resistant (MDR) pathogenic fungus, Candida auris came to light in 2009. This particular organism is capable of causing nosocomial infections in immunecompromised persons. This pathogen is associated with consistent candidemia with high mortality rate and presents a serious global health threat. Whole genome sequence (WGS) investigation detected powerful phylogeographic Candida auris genotypes which are specialized to particular geological areas indicating dissemination of particular genotype among provinces. Furthermore, this organism frequently exhibits multidrug-resistance and displays an unusual sensitivity profile. Identification techniques that are commercialized to test Candida auris often show inconsistent results and this misidentification leads to treatment failure which complicates the management of candidiasis. Till date, Candida auris has been progressively recorded from several countries and therefore its preventive control measures are paramount to interrupt its transmission. In this review, we discussed prevalence, biology, drug-resistance phenomena, virulence factors and management of Candida auris infections.

scholarly journals 855. Significance of Invasive Infections due to Methicillin Sensitive Staphylococcus aureus in the neonatal population

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S468-S468
Author(s):  
Mariawy Riollano ◽  
Deena Altman ◽  
shanna kowalsky ◽  
Stephanie Pan
Keyword(s):  
Staphylococcus Aureus ◽  
Clinical Characteristics ◽  
Invasive Disease ◽  
Control Measures ◽  
Invasive Infection ◽  
Single Center ◽  
Infection Control Measures ◽  
Invasive Infections ◽  
Mrsa Colonization ◽  
Neonatal Population

Abstract Background Staphylococcus aureus is a well-known cause of hospital acquired infections. Methicillin resistant staphylococcus aureus (MRSA) colonization is a recognized risk factor for invasive infections. The neonatal population in the intensive care unit (NICU) is particularly vulnerable to these types of infections, resulting in high mortality and morbidity. However, only scant data is available to establish the risk for invasive disease in patients with Methicillin sensitive staphylococcus aureus (MSSA). As a result, surveillance and prevention strategies are only address for MRSA colonization. Here, we describe the clinical characteristics of S. aureus colonized patients identified in late 2018 during transmission events in a single center NICU. As a result of the targeted surveillance investigation for MRSA infection control measures, S. aureus colonization was stratified, and we were able to compare the differences in invasive disease between MRSA and MSSA. Methods This is a retrospective chart review of the 47 colonized patients identified during October 2018- January 2019 SA transmission events in single center NICU. Risk factors, clinical characteristics, and the hospital course of these cases, including the proportion of invasive illness were reviewed. Results We found that most clinical characteristic, risk factors, and hospital course were the same between MRSA and MSSA colonized infants (p values > 0.05). Additionally, there was no difference in the proportion of invasive infection between MRSA and MSSA colonized patients (p value > 0.05). The type of invasive infections identified were SSTI, bacteremia, and osteomyelitis. Conclusion The proportion of invasive infection was the same in MSSA and MRSA colonized patients. This data provides us with supportive material for future recommendations of infection control measures for MSSA colonized patients. Disclosures All Authors: No reported disclosures

scholarly journals The Fungal Cyp51-Specific Inhibitor VT-1598 DemonstratesIn VitroandIn VivoActivity againstCandida auris

2018 ◽  
Vol 63 (3) ◽  
Author(s):  
Nathan P. Wiederhold ◽  
Shawn R. Lockhart ◽  
Laura K. Najvar ◽  
Elizabeth L. Berkow ◽  
Rosie Jaramillo ◽  
...  
Keyword(s):  
Specific Inhibitor ◽  
Candida Auris ◽  
Once Daily ◽  
Content Type ◽  
Fungal Burden ◽  
Invasive Infections ◽  
Trough Concentrations ◽  
Dose Dependent

ABSTRACTCandida aurisis an emerging pathogen associated with significant mortality and often multidrug resistance. VT-1598, a tetrazole-based fungal CYP51-specific inhibitor, was evaluatedin vitroandin vivoagainstC. auris. Susceptibility testing was performed against 100 clinical isolates ofC. aurisby broth microdilution. Neutropenic mice were infected intravenously withC. auris, and treatment began 24 h postinoculation with a vehicle control, oral VT-1598 (5, 15, and 50 mg/kg of body weight once daily), oral fluconazole (20 mg/kg once daily), or intraperitoneal caspofungin (10 mg/kg once daily), which continued for 7 days. Fungal burden was assessed in the kidneys and brains on day 8 in the fungal burden arm and on the days the mice succumbed to infection or on day 21 in the survival arm. VT-1598 plasma trough concentrations were also assessed on day 8. VT-1598 demonstratedin vitroactivity againstC. auris, with a mode MIC of 0.25 μg/ml and MICs ranging from 0.03 to 8 μg/ml. Treatment with VT-1598 resulted in significant and dose-dependent improvements in survival (median survival, 15 and >21 days for VT-1598 at 15 and 50 mg/kg, respectively) and reductions in kidney and brain fungal burden (reductions of 1.88 to 3.61 log10CFU/g) compared to the control (5 days). The reductions in fungal burden correlated with plasma trough concentrations. Treatment with caspofungin, but not fluconazole, also resulted in significant improvements in survival and reductions in fungal burden compared to those with the control. These results suggest that VT-1598 may be a future option for the treatment of invasive infections caused byC. auris.

scholarly journals Invasive Infections with Multidrug-Resistant Yeast Candida auris, Colombia

2017 ◽  
Vol 23 (1) ◽  
pp. 162-164 ◽  
Author(s):  
Soraya E. Morales-López ◽  
Claudia M. Parra-Giraldo ◽  
Andrés Ceballos-Garzón ◽  
Heidys P. Martínez ◽  
Gerson J. Rodríguez ◽  
...  
Keyword(s):  
Multidrug Resistant ◽  
Candida Auris ◽  
Invasive Infections

Communicable diseases in humanitarian operations and disasters

2020 ◽  
pp. bmjmilitary-2020-001415 ◽  
Author(s):  
Ronan James Murphy
Keyword(s):  
Communicable Disease ◽  
Evidence Base ◽  
Multidrug Resistant ◽  
Communicable Diseases ◽  
Control Measures ◽  
Diagnostic Tools ◽  
Humanitarian Operations ◽  
The Uk ◽  
Tools And Techniques ◽  
Austere Environments

Military organisations have battled communicable disease for millennia. They have pioneered disease prevention from the Crusades to the World Wars and continue to do so today. Predeployment vaccinations and chemoprophylaxis are effective in preventing communicable disease, as is reliable vector destruction and bite prevention, especially in the era of multidrug resistant organisms. These measures are unlikely to be fully possible in disasters, but reactive vaccination and efforts to reduce exposure to communicable disease should be a priority. Communicable diseases can be challenging to diagnose—the UK Defence Medical Services have become familiar with tools such as multiplex PCR and mass spectrometry. These have the potential to accurately identify organisms and sensitivity patterns in austere environments. Management of communicable diseases depends on accurate diagnosis and has a largely well-established evidence base but can be limited by a lack of resources and skills in an austere setting, therefore telemedicine can assist diagnosis and treatment of infections by projecting specialist skill. Systems such as EpiNATO2 are useful in monitoring diseases and identifying trends in order to establish control measures. Many of these tools and techniques are effective in austere environments and offer learning opportunities for those providing care in similar settings. Further research is ongoing into diagnostic tools as well as remote management.

scholarly journals Insights into the Unique Nature of the East Asian Clade of the Emerging Pathogenic Yeast Candida auris

2019 ◽  
Vol 57 (4) ◽  
Author(s):  
Rory M. Welsh ◽  
D. Joseph Sexton ◽  
Kaitlin Forsberg ◽  
Snigdha Vallabhaneni ◽  
Anastasia Litvintseva
Keyword(s):  
Large Scale ◽  
East Asian ◽  
Candida Auris ◽  
Pathogenic Yeast ◽  
Content Type ◽  
New Information ◽  
Asian Clade ◽  
Single Region ◽  
Invasive Infections ◽  
Unique Nature

ABSTRACT The emerging yeast Candida auris can be highly drug resistant, causing invasive infections, and large outbreaks. C. auris went from an unknown pathogen a decade ago to being reported in over thirty countries on six continents. C. auris consists of four discrete clades, based on where the first isolates of the clade were reported, South Asian (clade I), East Asian (clade II), African (clade III), and South American (clade IV). These clades have unique genetic and biochemical characteristics that are important to understand and inform the global response to C. auris. Clade II has been underrepresented in the literature despite being the first one discovered. In this issue of the Journal of Clinical Microbiology, Y. J. Kwon et al. (J Clin Microbiol 57:e01624-18, 2019, https://doi.org/10.1128/JCM.01624-18) describe the largest collection of clinical isolates from Clade II, which is also the longest-running span of clinical cases, 20 years, from any single region to date. Clade II appears to have a propensity for the ear that is uncharacteristic of the other clades, which typically cause invasive infections and large-scale outbreaks. This study provides new information on an understudied lineage of C. auris and has important implications for future surveillance.

scholarly journals 161. Prevalence and Risk Factors for Candida auris Colonization Among Patients in a Long-term Acute Care Hospital—New Jersey, 2017

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S14-S14
Author(s):  
Faye Rozwadowski ◽  
Jarred McAteer ◽  
Nancy A Chow ◽  
Kimberly Skrobarcek ◽  
Kaitlin Forsberg ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Care ◽  
Acute Care Hospital ◽  
Clinical Information ◽  
Control Measures ◽  
Resistant Organism ◽  
Invasive Infection ◽  
Care Hospital ◽  
Candida Auris

Abstract Background Candida auris can be transmitted in healthcare settings, and patients can become asymptomatically colonized, increasing risk for invasive infection and transmission. We investigated an ongoing C. auris outbreak at a 30-bed long-term acute care hospital to identify colonization for C. auris prevalence and risk factors. Methods During February–June 2017, we conducted point prevalence surveys every 2 weeks among admitted patients. We abstracted clinical information from medical records and collected axillary and groin swabs. Swabs were tested for C. auris. Data were analyzed to identify risk factors for colonization with C. auris by evaluating differences between colonized and noncolonized patients. Results All 101 hospitalized patients were surveyed, and 33 (33%) were colonized with C. auris. Prevalence of colonization ranged from 8% to 38%; incidence ranged from 5% to 20% (figure). Among colonized patients with available data, 19/27 (70%) had a tracheostomy, 20/31 (65%) had gastrostomy tubes, 24/33 (73%) ventilator use, and 12/27 (44%) had hemodialysis. Also, 31/33 (94%) had antibiotics and 13/33 (34%) antifungals during hospitalization. BMI for colonized patients (mean = 30.3, standard deviation (SD) = 10) was higher than for noncolonized patients (mean = 26.5, SD = 7.9); t = −2.1; P = 0.04). Odds of colonization were higher among Black patients (33%) vs. White patients (16%) (odds ratio [OR] 3.5; 95% confidence interval [CI] 1.3–9.8), and those colonized with other multidrug-resistant organism (MDRO) (72%) vs. noncolonized (44%) (OR 3.2; CI 1.3–8.0). Odds of death were higher among colonized patients (OR 4.6; CI 1.6—13.6). Conclusion Patients in long-term acute care facilities and having high prevalences of MDROs might be at risk for C. auris. Such patients with these risk factors could be targeted for enhanced surveillance to facilitate early detection of C. auris. Infection control measures to reduce MDROs’ spread, including hand hygiene, contact precautions, and judicious use of antimicrobials, could prevent further C. auris transmission. Acknowledgements The authors thank Janet Glowicz and Kathleen Ross. Disclosures All authors: No reported disclosures.

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