Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Medical Microbiology and Immunology, St Antonius Hospital, Nieuwegein, The Netherlands.
J Hosp Infect. 2024 Apr;146:31-36. doi: 10.1016/j.jhin.2023.12.019. Epub 2024 Jan 27.
Candida auris is an emerging multidrug-resistant yeast which can cause severe infection in hospitalized patients. Since its first detection in 2009, C. auris has spread globally. The control and elimination of this pathogen in a hospital setting is particularly challenging because of its ability to form biofilms, allowing for long-term patient colonization and persistence in the environment. Identification of C. auris from cultures is difficult due to the morphologic similarities to other yeasts, its slow growth, and the low culture sensitivity when using standard agars and temperatures.
We have developed a screening protocol for C. auris colonization using an in-house-developed polymerase chain reaction (PCR), combined with confirmatory culture in optimized conditions.
C. auris-specific primers and probe were developed, targeting the internal transcribed spacer (ITS) region, and specificity was confirmed in silico using the BLAST tool. The PCR was validated using a panel of 12 C. auris isolates and 103 isolates from 22 other Candida species and was shown to be 100% accurate. The limit of detection of the assay was determined at approximately four cells per PCR.
C. auris screening was introduced on February 15, 2023, and was used for patients who had been admitted to a healthcare facility abroad in the two months prior to admission to our hospital. The screening protocol included swabs from nose, throat, rectum, axilla, and groin. In the first eight months, 199 patients were screened and seven were found positive (4%).
Our proposed screening protocol may contribute to control C. auris in hospitals.
耳念珠菌是一种新兴的多药耐药酵母菌，可导致住院患者发生严重感染。自 2009 年首次发现以来，耳念珠菌已在全球范围内传播。由于其形成生物膜的能力，使得患者长期定植和在环境中持续存在，因此在医院环境中控制和消除这种病原体极具挑战性。由于其形态与其他酵母菌相似、生长缓慢以及在使用标准琼脂和温度时培养敏感性较低，因此从培养物中鉴定耳念珠菌较为困难。
我们开发了一种使用内部开发的聚合酶链反应（PCR）筛选耳念珠菌定植的方案，结合优化条件下的确认性培养。
开发了耳念珠菌特异性引物和探针，靶向内部转录间隔区（ITS）区域，并使用 BLAST 工具在计算机上确认其特异性。使用 12 株耳念珠菌分离株和 22 种其他念珠菌属的 103 株分离株对 PCR 进行验证，结果显示其准确率为 100%。该检测方法的检测限约为每个 PCR 约 4 个细胞。
2023 年 2 月 15 日引入了耳念珠菌筛查，用于在我院住院前两个月内曾在国外医疗机构住院的患者。筛查方案包括鼻、咽、直肠、腋窝和腹股沟拭子。在前八个月中，对 199 名患者进行了筛查，发现 7 例阳性（4%）。
我们提出的筛查方案可能有助于控制医院中的耳念珠菌。
