Moreno María Victoria, Simian María Elvira, Villarroel Javier, Fuenzalida Luz María, Yarad María Fernanda, Soto Andrés, Silva Verónica, Pimentel Ximena
Laboratorio Clínico, Hospital del Salvador, Santiago, Chile.
Programa de Formación en Microbiología, Facultad de Medicina, Universidad de Chile, Chile.
Rev Chilena Infectol. 2019 Dec;36(6):767-773. doi: 10.4067/S0716-10182019000600767.
Candida auris is an emerging multi-drug-resistant fungus that is rapidly spreading worldwide. Since the first reports in 2009, many isolates across five continents have been identified as agents of hospital-associated infections. Independent and simultaneous outbreaks of C. auris are becoming a major concern for healthcare and scientific community. Moreover, laboratory misidentification and multi-drug-resistant profiles, rarely observed for other non-albicans Candida species, result in difficult eradication and frequent therapeutic failures of C. auris infections. In this article we present the first case of isolation of a strain of C. auris at a hospital in Santiago, in a patient coming from India, who was admitted for treatment of diabetic foot complications. The strain was recovered from a tissue culture and identified by VITEK® 2 Compact. The accurate identification of C. auris was confirmed by means of MALDI-TOF MS and DNA sequence analysis. The isolate was resistant to fluconazole, retaining only susceptibility to amphotericin and caspofungin with MIC breakpoints recommended by CDC. The emergence of C. auris is alarming because the mode of transmission within the healthcare environment is not clear and is likely to be multifactorial.
耳念珠菌是一种新出现的多重耐药真菌,正在全球迅速传播。自2009年首次报告以来,五大洲的许多分离株已被鉴定为医院感染的病原体。耳念珠菌独立且同时爆发正成为医疗保健和科学界的主要担忧。此外,实验室错误鉴定和多重耐药谱,在其他非白念珠菌物种中很少见,导致耳念珠菌感染难以根除且治疗失败频繁。在本文中,我们报告了在圣地亚哥一家医院首次分离出耳念珠菌菌株的病例,该患者来自印度,因糖尿病足并发症入院治疗。该菌株从组织培养物中分离出来,并通过VITEK® 2 Compact进行鉴定。通过MALDI-TOF MS和DNA序列分析确认了耳念珠菌的准确鉴定。该分离株对氟康唑耐药,仅对两性霉素和卡泊芬净敏感,其MIC断点符合美国疾病控制与预防中心(CDC)的推荐。耳念珠菌的出现令人担忧,因为其在医疗环境中的传播模式尚不清楚,且可能是多因素的。