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Candida auris outbreak involving liver transplant recipients in a surgical intensive care unit
Author(s) -
Theodoropoulos Nicole M.,
Bolstorff Barbara,
Bozorgzadeh Adel,
Brandeburg Christina,
Cumming Melissa,
Daly Jennifer S.,
Ellison Richard T.,
Forsberg Kaitlin,
Gade Lalitha,
Gibson Laura,
Greenough Thomas,
Litvintseva Anastasia P.,
Mack Deborah A.,
Madoff Lawrence,
Martins Paulo N.,
McHale Eileen,
Melvin Zita,
Movahedi Babak,
Stiles Tracy,
Vallabhaneni Snigdha,
Levitz Stuart M.
Publication year - 2020
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.16144
Subject(s) - candida auris , outbreak , medicine , infection control , intensive care unit , fluconazole , intensive care medicine , virology , antifungal , dermatology
Candida auris is a yeast that is difficult to eradicate and has caused outbreaks in health care facilities. We report a cluster of 5 patients in 1 intensive care unit who were colonized or infected in 2017. The initial 2 patients were recipients of liver transplants who had cultures that grew C auris within 3 days of each other in June 2017 (days 43 and 30 posttransplant). Subsequent screening cultures identified 2 additional patients with C auris colonization. Respiratory and urine cultures from a fifth patient yielded C auris . All isolates were fluconazole resistant but susceptible to echinocandins. Whole genome sequencing showed the strains were clonal, suggesting in‐hospital transmission, and related but distinct from New York/New Jersey strains, consistent with a separate introduction. However, no source or contact was found. Two of the 5 patients died. C auris infection likely contributed to 1 patient death by infecting a vascular aneurysm at the graft anastomosis. Strict infection control precautions were initiated to control the outbreak. Our experience reveals that although severe disease from C auris can occur in transplant recipients, outbreaks can be controlled using recommended infection control practices. We have had no further patients infected with C auris to date.