Dataset Information

Management of Patients with Candida auris Fungemia at Community Hospital, Brooklyn, New York, USA, 2016-2018¹.

ABSTRACT: Candida auris is an emerging fungus that can cause invasive infections. It is associated with high mortality rates and resistance to multiple classes of antifungal drugs and is difficult to identify with standard laboratory methods. We describe the management and outcomes of 9 patients with C. auris fungemia in Brooklyn, New York, USA.

SUBMITTER: Park JY

PROVIDER: S-EPMC6390749 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Publications

Management of Patients with Candida auris Fungemia at Community Hospital, Brooklyn, New York, USA, 2016-2018<sup>1</sup>.

Park Jenny YeiSol JY Bradley Nicole N Brooks Steven S Burney Sibte S Wassner Chanie C

Emerging infectious diseases 20190301 3

Candida auris is an emerging fungus that can cause invasive infections. It is associated with high mortality rates and resistance to multiple classes of antifungal drugs and is difficult to identify with standard laboratory methods. We describe the management and outcomes of 9 patients with C. auris fungemia in Brooklyn, New York, USA. ...[more]

PMID: 30789336

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Project description:Candida auris is a multidrug-resistant yeast which has emerged in health care facilities worldwide; however, little is known about identification methods, patient colonization, environmental survival, spread, and drug resistance. Colonization on both biotic (patients) and abiotic (health care objects) surfaces, along with travel, appear to be the major factors for the spread of this pathogen across the globe. In this investigation, we present laboratory findings from an ongoing C. auris outbreak in New York (NY) from August 2016 through 2018. A total of 540 clinical isolates, 11,035 patient surveillance specimens, and 3,672 environmental surveillance samples were analyzed. Laboratory methods included matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) for yeast isolate identification, real-time PCR for rapid surveillance sample screening, culture on selective/nonselective media for recovery of C. auris and other yeasts from surveillance samples, antifungal susceptibility testing to determine the C. auris resistance profile, and Sanger sequencing of the internal transcribed spacer (ITS) and D1/D2 regions of the ribosomal gene for C. auris genotyping. Results included (a) identification and confirmation of C. auris in 413 clinical isolates and 931 patient surveillance isolates as well as identification of 277 clinical cases and 350 colonized cases from 151 health care facilities, including 59 hospitals, 92 nursing homes, 1 long-term acute care hospital (LTACH), and 2 hospices, (b) successful utilization of an in-house developed C. auris real-time PCR assay for the rapid screening of patient and environmental surveillance samples, (c) demonstration of relatively heavier colonization of C. auris in nares than in the axilla/groin, and (d) predominance of the South Asia clade I with intrinsic resistance to fluconazole and elevated MIC to voriconazole (81%), amphotericin B (61%), flucytosine (5FC) (3%), and echinocandins (1%). These findings reflect greater regional prevalence and incidence of C. auris and the deployment of better detection tools in an unprecedented outbreak.

Project description:Since 2016, in Colombia, ongoing transmission of Candida auris has been reported in multiple cities. Here, we provide an updated description of C. auris genomic epidemiology and the dynamics of antifungal resistance in Colombia. We sequenced 99 isolates from C. auris cases with collection dates ranging from June 2016 to January 2021; the resulting sequences coupled with 103 previously generated sequences from C. auris cases were described in a phylogenetic analysis. All C. auris cases were clade IV. Of the 182 isolates with antifungal susceptibility data, 67 (37%) were resistant to fluconazole, and 39 (21%) were resistant to amphotericin B. Isolates predominately clustered by country except for 16 isolates from Bogotá, Colombia, which grouped with isolates from Venezuela. The largest cluster (N = 166 isolates) contained two subgroups. The first subgroup contained 26 isolates, mainly from César; of these, 85% (N = 22) were resistant to fluconazole. The second subgroup consisted of 47 isolates from the north coast; of these, 81% (N = 38) were resistant to amphotericin B. Mutations in the ERG11 and TAC1B genes were identified in fluconazole-resistant isolates. This work describes molecular mechanisms associated with C. auris antifungal resistance in Colombia. Overall, C. auris cases from different geographic locations in Colombia exhibited high genetic relatedness, suggesting continued transmission between cities since 2016. These findings also suggest a lack of or minimal introductions of different clades of C. auris into Colombia.ImportanceCandida auris is an emerging fungus that presents a serious global health threat and has caused multiple outbreaks in Colombia. This work discusses the likelihood of introductions and local transmission of C. auris and provides an updated description of the molecular mechanisms associated with antifungal resistance in Colombia. Efforts like this provide information about the evolving C. auris burden that could help guide public health strategies to control C. auris spread.

Dataset Information

Management of Patients with Candida auris Fungemia at Community Hospital, Brooklyn, New York, USA, 2016-2018¹.

Publications

Management of Patients with Candida auris Fungemia at Community Hospital, Brooklyn, New York, USA, 2016-2018<sup>1</sup>.

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Dataset Information

Management of Patients with Candida auris Fungemia at Community Hospital, Brooklyn, New York, USA, 2016-20181.

Publications

Management of Patients with Candida auris Fungemia at Community Hospital, Brooklyn, New York, USA, 2016-2018<sup>1</sup>.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Management of Patients with Candida auris Fungemia at Community Hospital, Brooklyn, New York, USA, 2016-2018¹.