Archive for January 19, 2017

Invasive Infections with Multidrug-Resistant Yeast Candida auris, Colombia.

Emerg Infect Dis. 2017 Jan;23(1):162-164.

Morales-López SE, Parra-Giraldo CM, Ceballos-Garzón A, Martínez HP, Rodríguez GJ, Álvarez-Moreno CA, Rodríguez JY.

Abstract

Candida auris is an emerging multidrug-resistant fungus that causes a wide range of symptoms. We report finding 17 cases of C. auris infection that were originally misclassified but correctly identified 27.5 days later on average. Patients with a delayed diagnosis of C. auris had a 30-day mortality rate of 35.2%.

PDF

https://wwwnc.cdc.gov/eid/article/23/1/pdfs/16-1497.pdf

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January 19, 2017 at 8:24 am

First hospital outbreak of the globally emerging Candida auris in a European hospital.

Antimicrob Resist Infect Control. 2016 Oct 19;5:35. eCollection 2016.

Schelenz S1, Hagen F2, Rhodes JL3, Abdolrasouli A3, Chowdhary A4, Hall A5, Ryan L5, Shackleton J5, Trimlett R6, Meis JF7, Armstrong-James D1, Fisher MC3.

Author information

1Department of Microbiology, Royal Brompton Hospital, London, UK ; Department of Infectious Disease Epidemiology, Imperial College School of Public Health, St Mary’s Campus, London, UK.

2Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital (CWZ), Nijmegen, The Netherlands.

3Department of Infectious Disease Epidemiology, Imperial College School of Public Health, St Mary’s Campus, London, UK.

4Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India.

5Department of Microbiology, Royal Brompton Hospital, London, UK.

6Department of Surgery, Royal Brompton Hospital, London, UK.

7Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital (CWZ), Nijmegen, The Netherlands ; Radboudumc/CWZ Centre of Expertise in Mycology, Nijmegen, The Netherlands.

Abstract

BACKGROUND:

Candida auris is a globally emerging multidrug resistant fungal pathogen causing nosocomial transmission. We report an ongoing outbreak of C. auris in a London cardio-thoracic center between April 2015 and July 2016. This is the first report of C. auris in Europe and the largest outbreak so far. We describe the identification, investigation and implementation of control measures.

METHODS:

Data on C. auris case demographics, environmental screening, implementation of infection prevention/control measures, and antifungal susceptibility of patient isolates were prospectively recorded then analysed retrospectively. Speciation of C. auris was performed by MALDI-TOF and typing of outbreak isolates performed by amplified fragment length polymorphism (AFLP).

RESULTS:

This report describes an ongoing outbreak of 50 C. auris cases over the first 16 month (April 2015 to July 2016) within a single Hospital Trust in London. A total of 44 % (n = 22/50) patients developed possible or proven C. auris infection with a candidaemia rate of 18 % (n = 9/50). Environmental sampling showed persistent presence of the yeast around bed space areas. Implementation of strict infection and prevention control measures included: isolation of cases and their contacts, wearing of personal protective clothing by health care workers, screening of patients on affected wards, skin decontamination with chlorhexidine, environmental cleaning with chorine based reagents and hydrogen peroxide vapour. Genotyping with AFLP demonstrated that C. auris isolates from the same geographic region clustered.

CONCLUSION:

This ongoing outbreak with genotypically closely related C. auris highlights the importance of appropriate species identification and rapid detection of cases in order to contain hospital acquired transmission

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5069812/pdf/13756_2016_Article_132.pdf

January 19, 2017 at 8:23 am

Comparative Pathogenicity of United Kingdom Isolates of the Emerging Pathogen Candida auris and Other Key Pathogenic Candida Species.

mSphere. 2016 Aug 18;1(4). pii: e00189-16. doi: 10.1128/mSphere.00189-16.

Borman AM1, Szekely A1, Johnson EM1.

Author information

1UK National Mycology Reference Laboratory (MRL), Public Health England South-West, Bristol, United Kingdom.

Abstract

Candida auris, first described in 2009, has since emerged as an important, multidrug-resistant, nosocomial agent of candidemia, with large outbreaks reported worldwide and high mortality rates associated with therapeutic failure. The current study employed C. auris isolates from a variety of centers in the United Kingdom to evaluate the pathogenicity of this emerging pathogen compared to that of other common pathogenic yeast species in the invertebrate Galleria mellonella infection model. We showed that C. auris isolates differ in their growth characteristics in vitro, with a proportion of isolates failing to release daughter cells after budding, resulting in the formation of large aggregates of cells that cannot be physically disrupted. Our results also demonstrate strain-specific differences in the behavior of C. auris in G. mellonella, with the aggregate-forming isolates exhibiting significantly less pathogenicity than their nonaggregating counterparts. Importantly, the nonaggregating isolates exhibited pathogenicity comparable to that of C. albicans, which is currently accepted as the most pathogenic member of the genus, despite the fact that C. auris isolates do not produce hyphae and produce only rudimentary pseudohyphae either in vitro or in G. mellonella.

IMPORTANCE The incidence of invasive candidiasis, which includes candidemia and deep tissue infections, continues to rise and is associated with considerable mortality rates. Candida albicans remains the most common cause of invasive candidiasis, although the prevalence of non-albicans species has increased over recent years. Since its first description in 2009, Candida auris has emerged as a serious nosocomial health risk, with widespread outbreaks in numerous hospitals worldwide. However, despite receiving considerable attention, little is known concerning the pathogenicity of this emerging fungal pathogen. Here, using the Galleria mellonella insect systemic infection model, we show strain-specific differences in the virulence of C. auris, with the most virulent isolates exhibiting pathogenicity comparable to that of C. albicans, which is currently accepted as the most pathogenic member of the genus.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4990711/pdf/mSphere.00189-16.pdf

January 19, 2017 at 8:22 am


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