Increasing number of cases and outbreaks caused by Candida auris in the EU/EEA, 2020 to 2021

Kohlenberg, Anke; Monnet, Dominique; Plachouras, Diamantis

doi:10.2807/1560-7917.es.2022.27.46.2200846

Cited by 36 publications

(26 citation statements)

References 13 publications

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“…In LMIC, a lack of laboratory capability for routine fungal detection and surveillance can lead to delayed microbiologic identification until spread has already occurred. Numerous outbreaks due to C. auris infection in the healthcare setting were reported from countries worldwide [ 61 , 62 ]. These hospital outbreaks have been difficult to control despite enhanced control measures.…”

Section: Discussionmentioning

confidence: 99%

Antifungal Drug Resistance: An Emergent Health Threat

Vitiello

Ferrara²,

Boccellino

et al. 2023

Biomedicines

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Fungal infections, named mycosis, can cause severe invasive and systemic diseases that can even lead to death. In recent years, epidemiological data have recorded an increase in cases of severe fungal infections, caused mainly by a growing number of immunocompromised patients and the emergence of fungal pathogenic forms that are increasingly resistant to antimycotic drug treatments. Consequently, an increase in the incidence of mortality due to fungal infections has also been observed. Among the most drug-resistant fungal forms are those belonging to the Candida and Aspergillus spp. Some pathogens are widespread globally, while others are endemic in some areas only. In addition, some others may represent a health threat for some specific subpopulations and not for the general public. In contrast to the extensive therapeutic armamentarium available for the antimicrobial chemotherapeutic treatment of bacteria, for fungal infections there are only a few classes of antimycotic drugs on the market, such as polyenes, azoles, echinocandins, and a few molecules are under trial. In this review, we focused on the systemic mycosis, highlighted the antifungal drug compounds available in the pipeline, and analyzed the main molecular mechanisms for the development of antifungal resistance to give a comprehensive overview and increase awareness on this growing health threat.

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Section: Discussionmentioning

confidence: 99%

Antifungal Drug Resistance: An Emergent Health Threat

Vitiello

Ferrara²,

Boccellino

et al. 2023

Biomedicines

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“…From 2019–2021 74 cases and outbreaks in Greece have been reported including 58 cases in 2021, thus indicating a significant increase of cases in Greece. However, no further information which can be linked to our case has been made available [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Candida auris in Austria—What Is New and What Is Different

Spettel

Kriz

et al. 2023

JoF

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Candida auris is a novel and emerging pathogenic yeast which represents a serious global health threat. Since its first description in Japan 2009, it has been associated with large hospital outbreaks all over the world and is often resistant to more than one antifungal drug class. To date, five C. auris isolates have been detected in Austria. Morphological characterization and antifungal susceptibility profiles against echinocandins, azoles, polyenes and pyrimidines, as well as the new antifungals ibrexafungerp and manogepix, were determined. In order to assess pathogenicity of these isolates, an infection model in Galleria mellonella was performed and whole genome sequencing (WGS) analysis was conducted to determine the phylogeographic origin. We could characterize four isolates as South Asian clade I and one isolate as African clade III. All of them had elevated minimal inhibitory concentrations to at least two different antifungal classes. The new antifungal manogepix showed high in vitro efficacy against all five C. auris isolates. One isolate, belonging to the African clade III, showed an aggregating phenotype, while the other isolates belonging to South Asian clade I were non-aggregating. In the Galleria mellonella infection model, the isolate belonging to African clade III exhibited the lowest in vivo pathogenicity. As the occurrence of C. auris increases globally, it is important to raise awareness to prevent transmission and hospital outbreaks.

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“…The first outbreak of C. auris in Europe occurred in a London cardio-thoracic center between April 2015 and July 2016 [ 7 ]. C. auris outbreaks have been recently reported in five European Region countries (Denmark, France, Germany, Greece and Italy), while at least two of them in Germany and Italy involved COVID-19 patients or units dedicated to the care of COVID-19 patients [ 45 ]. C. auris transmission showed interregional spread and regional endemicity in one country (Spain).…”

Section: Discussionmentioning

confidence: 99%

Emergence of Clonally-Related South Asian Clade I Clinical Isolates of Candida auris in a Greek COVID-19 Intensive Care Unit

Katsiari

Mavroidi

Kesesidis

et al. 2023

JoF

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Candida auris has recently emerged as a multidrug-resistant yeast implicated in various healthcare-associated invasive infections and hospital outbreaks. In the current study, we report the first five intensive care unit (ICU) cases affected by C. auris isolates in Greece, during October 2020–January 2022. The ICU of the hospital was converted to a COVID-19 unit on 25 February 2021, during the third wave of COVID-19 in Greece. Identification of the isolates was confirmed by Matrix Assisted Laser Desorption Ionization Time of Flight mass spectroscopy (MALDI-TOF]. Antifungal susceptibility testing was performed by the EUCAST broth microdilution method. Based on the tentative CDC MIC breakpoints, all five C. auris isolates were resistant to fluconazole (≥32 μg/mL), while three of them exhibited resistance to amphotericin B (≥2 μg/mL). The environmental screening also revealed the dissemination of C. auris in the ICU. Molecular characterization of C. auris clinical and environmental isolates was performed by MultiLocus Sequence Typing (MLST) of a set of four genetic loci, namely ITS, D1/D2, RPB1 and RPB2, encoding for the internal transcribed spacer region (ITS) of the ribosomal subunit, the large ribosomal subunit region and the RNA polymerase II largest subunit, respectively. MLST analysis showed that all isolates possessed identical sequences in the four genetic loci and clustered with the South Asian clade I strains. Additionally, PCR amplification and sequencing of the CJJ09_001802 genetic locus, encoding for the “nucleolar protein 58” that contains clade-specific repeats was performed. Sanger sequence analysis of the TCCTTCTTC repeats within CJJ09_001802 locus also assigned the C. auris isolates to the South Asian clade I. Our study confirms that C. auris is an emerging yeast pathogen in our region, especially in the setting of the ongoing COVID-19 worldwide pandemic. Adherence to strict infection control is needed to restrain further spread of the pathogen.

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Increasing number of cases and outbreaks caused by Candida auris in the EU/EEA, 2020 to 2021

Cited by 36 publications

References 13 publications

Antifungal Drug Resistance: An Emergent Health Threat

Antifungal Drug Resistance: An Emergent Health Threat

Candida auris in Austria—What Is New and What Is Different

Emergence of Clonally-Related South Asian Clade I Clinical Isolates of Candida auris in a Greek COVID-19 Intensive Care Unit

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