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Molecular characterisation and clinical outcomes of Candida auris infection: Single‐centre experience in Saudi Arabia
Author(s) -
Almaghrabi Reem S.,
Albalawi Rashed,
Mutabagani Maysoon,
Atienza Edwin,
Aljumaah Suliman,
Gade Lalitha,
Forsberg Kaitlin,
Litvintseva Anastasia,
Althawadi Sahar
Publication year - 2020
Publication title -
mycoses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.13
H-Index - 69
eISSN - 1439-0507
pISSN - 0933-7407
DOI - 10.1111/myc.13065
Subject(s) - candida auris , fluconazole , outbreak , transmission (telecommunications) , biology , pathogen , clade , microbiology and biotechnology , whole genome sequencing , antifungal , virology , genome , genetics , phylogenetic tree , gene , electrical engineering , engineering
Summary 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 centre. 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 bloodstream infection. Thirty‐day mortality was higher in infected patients compared with those who were colonised. 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.