Section of Infectious Diseases, Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Department of Medicine, King Salman Armed Forces Hospital, Tabuk, Saudi Arabia.
Mycoses. 2020 May;63(5):452-460. doi: 10.1111/myc.13065. Epub 2020 Mar 3.
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.
To describe the clinical, molecular characteristics of Candida auris infection and clinical outcome in our centre.
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.
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.
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.
耳念珠菌是一种难以诊断的多重耐药酵母菌，可导致死亡率很高的侵袭性感染。自 2009 年出现以来，这种病原体与世界各地的许多疫情有关。全基因组测序（WGS）对于了解该病原体的出现和本地传播至关重要。
描述我们中心的耳念珠菌感染的临床、分子特征和临床结局。
从微生物数据库中确定了耳念珠菌阳性培养的患者。获得了临床特征和抗真菌药敏性。将分离株送往美国疾病控制与预防中心进行全基因组测序。
共确定了 7 例具有 8 种不同分离株的独特患者。将 7 个分离株送往美国疾病控制与预防中心进行全基因组测序。没有患者发生血流感染。与定植患者相比，感染患者的 30 天死亡率更高。8 株分离物中有 7 株对氟康唑和两性霉素 B 均耐药。WGS 分析表明，这 7 株分离株属于南亚分支，但形成了两个不同的亚分支，提示在该设施内存在两次独立的传入和持续传播。
耳念珠菌感染患者的死亡率很高。需要采取严格的感染控制措施和对无症状病例进行监测，以阻止持续传播。
