Candida auris: epidemiological situation, laboratory capacity and preparedness in European Union and European Economic Area countries, 2013 to 2017

Kohlenberg, Anke; Struelens, Marc; Monnet, Dominique; Plachouras, Diamantis

doi:10.2807/1560-7917.es.2018.23.13.18-00136

Cited by 74 publications

(66 citation statements)

References 12 publications

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“…We analyzed data for laboratory-confirmed candidemia only and did not include patients with other invasive Candida infections, culture-negative sepsis, or colonization, which might underestimate the extent of the problem in South Africa. However, 18%-22% of reported cases of C. auris infection in Europe and South Africa are bloodstream infections, and 58% of clinical isolates in the United States are from blood (1,19,30). In addition, 77% of cases of C. auris infection reported in the international literature are cases of candidemia; therefore, our study provides a plausible representation of the epidemiology of C. auris, albeit just the proverbial tip of the iceberg (3).…”

Section: Discussionmentioning

confidence: 96%

Epidemiologic Shift in Candidemia Driven by Candida auris, South Africa, 2016–20171

Schalkwyk¹,

Mpembe²,

Thomas³

et al. 2019

Emerg. Infect. Dis.

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Candida auris is an invasive healthcare-associated fungal pathogen. Cases of candidemia, defined as illness in patients with Candida cultured from blood, were detected through national laboratory-based surveillance in South Africa during 2016-2017. We identified viable isolates by using mass spectrometry and sequencing. Among 6,669 cases (5,876 with species identification) from 269 hospitals, 794 (14%) were caused by C. auris. The incidence risk for all candidemia at 133 hospitals was 83.8 (95% CI 81.2-86.4) cases/100,000 admissions. Prior systemic antifungal drug therapy was associated with a 40% increased adjusted odds of C. auris fungemia compared with bloodstream infection caused by other Candida species (adjusted odds ratio 1.4 [95% CI 0.8-2.3]). The crude in-hospital case-fatality ratio did not differ between Candida species and was 45% for C. auris candidemia, compared with 43% for non-C. auris candidemia. C. auris has caused a major epidemiologic shift in candidemia in South Africa.

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Section: Discussionmentioning

confidence: 96%

Epidemiologic Shift in Candidemia Driven by Candida auris, South Africa, 2016–20171

Schalkwyk¹,

Mpembe²,

Thomas³

et al. 2019

Emerg. Infect. Dis.

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“…APX001A also demonstrated activity against a range of rare Candida and other yeast species, with only Magnusiomyces capitatus, C. kefyr, and Cryptococcus neoformans being less susceptible than C. glabrata on a mg/liter basis. Of note, this included C. auris, an organism that is often drug or multidrug resistant, and which has emerged as a significant cause of nosocomial infections over the past 6 years in Asia, South Africa, Latin America, the United States, and in Europe (with cases in Spain, the United Kingdom, Germany, France, Belgium, Norway, and Austria) (8,11,12). This extends the findings of two recent reports studying a smaller number of C. auris isolates but confirming the in vitro activity in vivo using immunocompromised murine models of disseminated candidiasis (4, 7).…”

Section: Discussionmentioning

confidence: 99%

APX001A In Vitro Activity against Contemporary Blood Isolates and Candida auris Determined by the EUCAST Reference Method

Arendrup

Chowdhary

Astvad

et al. 2018

Antimicrob Agents Chemother

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APX001A is the active moiety of the first-in-class drug candidate APX001. So far, most susceptibility testing studies have examined ≤30 isolates/species, and only one used the EUCAST method. Here, we investigated the activity of APX001A and five comparators against 540 candidemia and 122 isolates. Isolates (17 and 3 yeast species) were identified using CHROMagar, matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF) and, when needed, internal transcribed space (ITS) sequencing. EUCAST E.Def 7.3.1 susceptibility testing included APX001A, amphotericin B, anidulafungin, micafungin, fluconazole, and voriconazole. Wild-type upper limits (WT-UL) were established following the EUCAST principles for epidemiological cutoff value setting for APX001A, allowing classification as wild type (WT) or non-WT. APX001A MIC values (mg/liter) were as follows: ,, and , 0.004 to 0.008; and , 0.016;, 0.06; and ,>0.5. APX001A MICs against the rare species varied from ≤0.0005 () to >0.5 (). APX001A was equally or more active than the comparators against all species except and Four isolates were APX001A non-WT; all were fluconazole resistant. A correlation was observed between APX001A and fluconazole MICs across all species except and , and when comparing high and low fluconazole MIC isolates of, ,, , and APX001A showed promising activity against most and other yeast species, including , compared to five comparators. WT-UL were suggested for the common species, and a new and unexplained correlation to fluconazole susceptibility was observed.

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“…This new species was closely related to Candida lusitaniae, C. pseudohaemulonii, C. duobushaemulonii and C. haemulonii , known as the C. haemulonii species complex . Currently, C. auris has been reported in >25 countries on five continents: North America, South America, Europe, Africa, and Asia . Unlike other yeasts, they are transmitted within and between hospitals, posing a serous public health threat .…”

Section: Introductionmentioning

confidence: 92%

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

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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.

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Candida auris: epidemiological situation, laboratory capacity and preparedness in European Union and European Economic Area countries, 2013 to 2017

Cited by 74 publications

References 12 publications

Epidemiologic Shift in Candidemia Driven by Candida auris, South Africa, 2016–20171

Epidemiologic Shift in Candidemia Driven by Candida auris, South Africa, 2016–20171

APX001A In Vitro Activity against Contemporary Blood Isolates and Candida auris Determined by the EUCAST Reference Method

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

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Candida auris: epidemiological situation, laboratory capacity and preparedness in European Union and European Economic Area countries, 2013 to 2017

Cited by 74 publications

References 12 publications

Epidemiologic Shift in Candidemia Driven by Candida auris, South Africa, 2016–20171

Epidemiologic Shift in Candidemia Driven by Candida auris, South Africa, 2016–20171

APX001A In Vitro Activity against Contemporary Blood Isolates and Candida auris Determined by the EUCAST Reference Method

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

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Product

Resources

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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