Reem S Almaghrabi1, Rashed Albalawi2, Maysoon Mutabagani3, Edwin Atienza3, Suliman Aljumaah4,5, Lalitha Gade6, Kaitlin Forsberg6, Anastasia Litvintseva6, Sahar Althawadi3. 1. Section of Infectious Diseases, Department of Medicine. King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. 2. Department of Medicine, King Salman Armed Forces Hospital. Northern Border, Tabuk, Saudi Arabia. 3. Section of Microbiology, Pathology and Laboratory Medicine. King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. 4. Section of Pediatric Infectious Diseases, Department of Pediatrics. King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. 5. Infection control and hospital epidemiology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. 6. Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
Abstract
BACKGROUND: Candida auris is a difficult-to-diagnose multidrug-resistant yeast that can cause invasive infections with high mortality. Since emerging in 2009, this pathogen has been associated with numerous outbreaks around the world. Whole genome sequencing (WGS) is instrumental for understanding the emergence and local transmission of this pathogen. OBJECTIVES: To describe the clinical, molecular characteristics of Candida auris infection and clinical outcome in our center. PATIENTS AND METHODS: Patients with positive cultures for Candida auris were identified in a microbiology database. Clinical characteristics and antifungal susceptibility were obtained. Isolates were sent to the US CDC for whole genome sequencing. RESULTS: Seven unique patients with eight different isolates were identified. Seven isolates were sent to the US CDC for whole genome sequencing. None of the patients had blood stream infection. 30-day mortality was higher in infected patients compared with those who were colonized. Seven of the eight isolates were resistant to both fluconazole and five were resistant to amphotericin B. WGS analysis demonstrated that the seven isolates belonged to the South Asian clade but formed two distinct subclades suggesting two independent introductions and ongoing transmission within the facility. CONCLUSIONS: Candida auris is associated with a high mortality rate in infected patients. Strict infection control measures and surveillance for asymptomatic cases are warranted to halt ongoing transmission. This article is protected by copyright. All rights reserved.
BACKGROUND:Candida auris is a difficult-to-diagnose multidrug-resistant yeast that can cause invasive infections with high mortality. Since emerging in 2009, this pathogen has been associated with numerous outbreaks around the world. Whole genome sequencing (WGS) is instrumental for understanding the emergence and local transmission of this pathogen. OBJECTIVES: To describe the clinical, molecular characteristics of Candida auris infection and clinical outcome in our center. PATIENTS AND METHODS: Patients with positive cultures for Candida auris were identified in a microbiology database. Clinical characteristics and antifungal susceptibility were obtained. Isolates were sent to the US CDC for whole genome sequencing. RESULTS: Seven unique patients with eight different isolates were identified. Seven isolates were sent to the US CDC for whole genome sequencing. None of the patients had blood stream infection. 30-day mortality was higher in infectedpatients compared with those who were colonized. Seven of the eight isolates were resistant to both fluconazole and five were resistant to amphotericin B. WGS analysis demonstrated that the seven isolates belonged to the South Asian clade but formed two distinct subclades suggesting two independent introductions and ongoing transmission within the facility. CONCLUSIONS:Candida auris is associated with a high mortality rate in infectedpatients. Strict infection control measures and surveillance for asymptomatic cases are warranted to halt ongoing transmission. This article is protected by copyright. All rights reserved.
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