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

January 19, 2017 at 8:23 am

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

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Entry filed under: Antimicoticos, Biología Molecular, Epidemiología, Health Care-Associated Infections, Infecciones emergentes, Infecciones micoticas, Metodos diagnosticos, REPORTS, Sepsis, Update.

Comparative Pathogenicity of United Kingdom Isolates of the Emerging Pathogen Candida auris and Other Key Pathogenic Candida Species. Invasive Infections with Multidrug-Resistant Yeast Candida auris, Colombia.


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