Molecular Epidemiological Investigation of a Nosocomial Cluster of C. auris: Evidence of Recent Emergence in Italy and Ease of Transmission during the COVID-19 Pandemic
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Open Access
- 15 February 2021
- journal article
- research article
- Published by MDPI AG in Journal of Fungi
- Vol. 7 (2), 140
- https://doi.org/10.3390/jof7020140
Abstract
Candida auris is an emerging MDR pathogen raising major concerns worldwide. In Italy, it was first and only identified in July 2019 in our hospital (San Martino Hospital, Genoa), where infection or colonization cases have been increasingly recognized during the following months. To gain insights into the introduction, transmission dynamics, and resistance traits of this fungal pathogen, consecutive C. auris isolates collected from July 2019 to May 2020 (n = 10) were subjected to whole-genome sequencing (WGS) and antifungal susceptibility testing (AST); patients’ clinical and trace data were also collected. WGS resolved all isolates within the genetic clade I (South Asian) and showed that all but one were part of a cluster likely stemming from the index case. Phylogenetic molecular clock analyses predicted a recent introduction (May 2019) in the hospital setting and suggested that most transmissions were associated with a ward converted to a COVID-19-dedicated ICU during the pandemic. All isolates were resistant to amphotericin B, voriconazole, and fluconazole at high-level, owing to mutations in ERG11(K143R) and TACB1(A640V). Present data demonstrated that the introduction of MDR C. auris in Italy was a recent event and suggested that its spread could have been facilitated by the COVID-19 pandemic. Continued efforts to implement stringent infection prevention and control strategies are warranted to limit the spread of this emerging pathogen within the healthcare system.Keywords
Funding Information
- Università degli Studi di Genova (FRA2018)
This publication has 37 references indexed in Scilit:
- Candida auris candidaemia in Indian ICUs: analysis of risk factorsJournal of Antimicrobial Chemotherapy, 2017
- Simultaneous Emergence of Multidrug-ResistantCandida aurison 3 Continents Confirmed by Whole-Genome Sequencing and Epidemiological AnalysesClinical Infectious Diseases, 2016
- Exploring the temporal structure of heterochronous sequences using TempEst (formerly Path-O-Gen)Virus Evolution, 2016
- Pilon: An Integrated Tool for Comprehensive Microbial Variant Detection and Genome Assembly ImprovementPLOS ONE, 2014
- IQ-TREE: A Fast and Effective Stochastic Algorithm for Estimating Maximum-Likelihood PhylogeniesMolecular Biology and Evolution, 2014
- Epidemiology and risk factors for invasive candidiasisTherapeutics and Clinical Risk Management, 2014
- Hidden Killers: Human Fungal InfectionsScience Translational Medicine, 2012
- Bayesian Phylogenetics with BEAUti and the BEAST 1.7Molecular Biology and Evolution, 2012
- Fast and accurate long-read alignment with Burrows–Wheeler transformBioinformatics, 2010
- Versatile and open software for comparing large genomesGenome Biology, 2004