A multicentre study of antifungal susceptibility patterns among 350 Candida auris isolates (2009–17) in India: role of the ERG11 and FKS1 genes in azole and echinocandin resistance

Chowdhary, Anuradha; Prakash, Anupam; Sharma, Cheshta; Kordalewska, Milena; Kumar, Anil; Sarma, Satyam; Tarai, Bansidhar; Singh, Ashutosh; Upadhyaya, Gargi; Upadhyay, Shalini; Yadav, Priyanka; Singh, Pradeep Kumar; Khillan, Vikas; Sachdeva, Neelam; Perlin, David S.; Meis, Jacques F.

doi:10.1093/jac/dkx480

Cited by 395 publications

(455 citation statements)

References 43 publications

Supporting

Mentioning

406

Contrasting

Unclassified

Order By: Relevance

“…Most worrying in our study was the low rate of susceptibility of C. auris to FLU (55%) and VRC (35%), two of the most commonly used “empiric” antifungals in Indian healthcare in cases of undiagnosed fever/sepsis when antibacterials alone prove ineffective . A recent study analysed 350 C. auris isolates collected from 10 hospitals from India reported that 90% of C. auris were FLU resistant (MICs 32 to ≥ 64 mg/L) . Interestingly, in contrast, 45% isolates in the present study had low MICs for FLU.…”

Section: Discussioncontrasting

confidence: 61%

“…Interestingly, in contrast, 45% isolates in the present study had low MICs for FLU. ERG11 sequences of C. auris have been reported to exhibit amino acid substitutions that have been previously identified in resistant but not in WT C. albicans isolates . The substitutions at positions Y132F and K143R responsible for azole resistance in C. albicans were observed in all 77% tested strains exhibiting FLU resistance (MICs 32 to≥ 64 mg/L), whereas WT genotypes that is without substitutions at these positions were observed in all isolates with low FLU MICs (1‐2 mg/L).…”

Section: Discussionmentioning

confidence: 86%

See 1 more Smart Citation

Five‐year profile of candidaemia at an Indian trauma centre: High rates of Candida auris blood stream infections

Mathur

Hasan

Singh

et al. 2018

Mycoses

Self Cite

View full text Add to dashboard Cite

Candidaemia is a potentially fatal infection with varied distribution of Candida species and their antifungal susceptibility profiles. The recent emergence of Candida auris in invasive candidiasis is a cause for concern. This study describes the profile of candidaemia at an Indian tertiary care hospital and reports the emergence of C. auris. All patients diagnosed with candidaemia between 2012 and 2017 were studied. The isolates were identified using conventional methods, VITEK 2 and MALDI-TOF MS. The isolates not identified by MALDI-TOF were sequenced. Antifungal susceptibility testing was done by the CLSI broth microdilution method and VITEK 2. A total of 114 isolates of Candida species were analysed. Candida tropicalis (39.4%) was the most common species, followed by C. auris (17.5%), C. albicans (14%) and C. parapsilosis (11.4%). Notably, Diutina mesorugosa isolates (n = 10) were not identified by MALDI-TOF and were confirmed by sequencing. Furthermore, 45% (n = 9) C. auris strains exhibited low MICs of FLU (0.05-4 μg/mL) and the remaining 55% (n = 11) isolates had high MICs ≥ 64 μg/mL. Also, D. mesorugosa exhibited high MICs of FLU (32 μg/mL) in 2 isolates. A high rate of errors in antifungal susceptibility was noted with the VITEK 2 as compared to the CLSI method. Candida auris was the second most prevalent species causing candidaemia warranting infection control practices to be strengthened to prevent its spread.

show abstract

Section: Discussioncontrasting

confidence: 61%

Section: Discussionmentioning

confidence: 86%

Five‐year profile of candidaemia at an Indian trauma centre: High rates of Candida auris blood stream infections

Mathur

Hasan

Singh

et al. 2018

Mycoses

Self Cite

View full text Add to dashboard Cite

show abstract

“…‘Resistance’ was more common among 350 isolates from India: fluconazole 90%, amphotericin B 8%, anidulafungin and micafungin 2%. Moreover, 25% were ‘resistant’ to two or more drug classes, and 13% were multi‐azole ‘resistant’ . Similarly, in New York, 98% of isolates were ‘resistant’ to fluconazole, and 25% ‘resistant’ to both fluconazole and amphotericin B .…”

Section: Laboratory Diagnosismentioning

confidence: 99%

“…Moreover, 25% were 'resistant' to two or more drug classes, and 13% were multi-azole 'resistant'. 15 Similarly, in New York, 98% of isolates were 'resistant' to fluconazole, and 25% 'resistant' to both fluconazole and amphotericin B. 22 In Spain, all isolates were fluconazoleand voriconazole-'resistant', whilst none was 'resistant' to echinocandins or amphotericin B.…”

Section: Genotypingmentioning

confidence: 99%

Diagnosis, management and prevention of Candida auris in hospitals: position statement of the Australasian Society for Infectious Diseases

Ong

Chen

Clark

et al. 2019

Internal Medicine Journal

View full text Add to dashboard Cite

Candida auris is an emerging drug‐resistant yeast responsible for hospital outbreaks. This statement reviews the evidence regarding diagnosis, treatment and prevention of this organism and provides consensus recommendations for clinicians and microbiologists in Australia and New Zealand. C. auris has been isolated in over 30 countries (including Australia). Bloodstream infections are the most frequently reported infections. Infections have crude mortality of 30–60%. Acquisition is generally healthcare‐associated and risks include underlying chronic disease, immunocompromise and presence of indwelling medical devices. C. auris may be misidentified by conventional phenotypic methods. Matrix‐assisted laser desorption ionisation time‐of‐flight mass spectrometry or sequencing of the internal transcribed spacer regions and/or the D1/D2 regions of the 28S ribosomal DNA are therefore required for definitive laboratory identification. Antifungal drug resistance, particularly to fluconazole, is common, with variable resistance to amphotericin B and echinocandins. Echinocandins are currently recommended as first‐line therapy for infection in adults and children ≥2 months of age. For neonates and infants <2 months of age, amphotericin B deoxycholate is recommended. Healthcare facilities with C. auris should implement a multimodal control response. Colonised or infected patients should be isolated in single rooms with Standard and Contact Precautions. Close contacts, patients transferred from facilities with endemic C. auris or admitted following stay in overseas healthcare institutions should be pre‐emptively isolated and screened for colonisation. Composite swabs of the axilla and groin should be collected. Routine screening of healthcare workers and the environment is not recommended. Detergents and sporicidal disinfectants should be used for environmental decontamination.

show abstract

“…Nevertheless, the inability of most available commercial identification methods to quickly diagnose C. auris remains a drawback to early therapy . There are currently no therapeutic guidelines, dosage or minimum inhibitory concentration (MIC) breakpoints for C. auris infections . Nosocomial transmission due to problematic environmental cleaning, poor treatment results and high mortalities are associated with C. auris infections worldwide.…”

Section: Introductionmentioning

confidence: 99%

Internal validation of GPS^™MONODOSE CanAur dtec‐qPCR kit following the UNE/EN ISO/IEC 17025:2005 for detection of the emerging yeast Candida auris

Martínez‐Murcia

Navarro²,

Bru³

et al. 2018

Mycoses

Self Cite

View full text Add to dashboard Cite

Candida auris is an emerging multidrug resistant pathogenic fungus that causes candidaemia with high mortality rates and exhibits the ability to persist within the hospital environment. Candida auris is phylogenetically closely related to Candida haemulonii, C. lusitaniae, C. pseudohaemulonii and C. duobushaemulonii and is frequently misidentified by commercial identification methods. In the present study, the GPS MONODOSE dtec-qPCR kit (dried single-dose PCR tubes) for the detection of C. auris was validated following the guidelines of the UNE/EN ISO/IEC 17025:2005, the French Standard NF T90-471:2010 and using fast-cycling protocols. Validation terms included in vitro specificity (inclusivity/exclusivity), quantitative phase analysis (10-10 standard DNA copies), reliability (repeatability/reproducibility) and sensitivity (detection/quantification limits). GPS dtec-qPCR kits passed validation with strict acceptance criteria (n ≥ 10 repetitions). In silico specificity was proven by the designer (GPS ). Experimental inclusiveness was achieved in two independent laboratories by testing strain JCM15448 and 117 clinical C. auris isolates from Asia, the Middle-East Africa, Latin America and Europe. Exclusiveness was evaluated with 25 strains of closely related Candida spp. Use of the MONODOSE format provided considerable advantages allowing the detection of C. auris to be accurately achieved in less than an hour. The GPS MONODOSE dtec-qPCR kit is ready to undergo clinical evaluation.

show abstract

A multicentre study of antifungal susceptibility patterns among 350 Candida auris isolates (2009–17) in India: role of the ERG11 and FKS1 genes in azole and echinocandin resistance

Abstract: Overall, 25% and 13% of isolates were MDR and multi-azole resistant, respectively. The most common resistance combination was azoles and 5-flucytosine in 14% followed by azoles and amphotericin B in 7% and azoles and echinocandins in 2% of isolates.

Cited by 395 publications

References 43 publications

Five‐year profile of candidaemia at an Indian trauma centre: High rates of Candida auris blood stream infections

Five‐year profile of candidaemia at an Indian trauma centre: High rates of Candida auris blood stream infections

Diagnosis, management and prevention of Candida auris in hospitals: position statement of the Australasian Society for Infectious Diseases

Internal validation of GPS^™MONODOSE CanAur dtec‐qPCR kit following the UNE/EN ISO/IEC 17025:2005 for detection of the emerging yeast Candida auris

Contact Info

Product

Resources

About

A multicentre study of antifungal susceptibility patterns among 350 Candida auris isolates (2009–17) in India: role of the ERG11 and FKS1 genes in azole and echinocandin resistance

Abstract: Overall, 25% and 13% of isolates were MDR and multi-azole resistant, respectively. The most common resistance combination was azoles and 5-flucytosine in 14% followed by azoles and amphotericin B in 7% and azoles and echinocandins in 2% of isolates.

Cited by 395 publications

References 43 publications

Five‐year profile of candidaemia at an Indian trauma centre: High rates of Candida auris blood stream infections

Five‐year profile of candidaemia at an Indian trauma centre: High rates of Candida auris blood stream infections

Diagnosis, management and prevention of Candida auris in hospitals: position statement of the Australasian Society for Infectious Diseases

Internal validation of GPS™MONODOSE CanAur dtec‐qPCR kit following the UNE/EN ISO/IEC 17025:2005 for detection of the emerging yeast Candida auris

Contact Info

Product

Resources

About

Internal validation of GPS^™MONODOSE CanAur dtec‐qPCR kit following the UNE/EN ISO/IEC 17025:2005 for detection of the emerging yeast Candida auris