The second confirmed case of Candida auris from Saudi Arabia

Elsawy, Abdelrahman; Alquthami, Khalid; Alkhutani, Nashwa; Marwan, Dalia; Abbas, Ammar

doi:10.1016/j.jiph.2019.07.011

Cited by 12 publications

(10 citation statements)

References 6 publications

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“…Concerning C. auris, it was associated with IC, mostly candidemia, in the United Arab Emirates, Kuwait, and Saudi Arabia [52,[63][64][65][66][67][68]. Surprisingly, while C. auris isolation in Kuwait has steadily increased over a study period and almost doubled in 2018 compared to 2017, a noteworthy finding of nearly sixfold increase was in bloodstream C. auris isolates in the same period [68].…”

Section: Invasive Candidiasismentioning

confidence: 94%

Update on invasive fungal infections in the Middle Eastern and North African region

et al. 2020

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In the recent years, the epidemiology of invasive fungal infections (IFIs) has changed worldwide. This is remarkably noticed with the significant increase in high-risk populations. Although surveillance of such infections is essential, data in the Middle Eastern and North African (MENA) region remain scarce. In this paper, we reviewed the existing data on the epidemiology of different IFIs in the MENA region. Epidemiological surveillance is crucial to guide optimal healthcare practices. This study can help to guide appropriate interventions and to implement antimicrobial stewardship and infection prevention and control programs in countries.

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Section: Invasive Candidiasismentioning

confidence: 94%

Update on invasive fungal infections in the Middle Eastern and North African region

et al. 2020

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“…In Saudi Arabia, the first two cases of C. auris were detected almost from one to three months after hospital admission and echinocandins had been used for successful treatment (13). Four more cases were reported, where 90% of the isolates were misidentified as C. haemulonii and in the same year, one case was confirmed via MALDI-TOF MS (14,27). Recently, a study reported high mortality rate of seven patients with C. auris infection (28).…”

Section: Resultsmentioning

confidence: 99%

“…Antifungal sensitivity of C. auris can be evaluated by using either microdilution or disk diffusion test. However, genotyping of ERG11 and FKS1 is the most valuable method to detect azole and echinocandin resistance and the efficacy of antifungal therapy (12) In 2018, the first two cases from Saudi Arabia were reported in 2018, followed by five cases of C. auris infection in two different cities (13,14). The aim of this study is to describe new cases of C. auris infection and to detect antifungal resistance genes namely, ERG11 and FKS1 in isolates of this global emerging pathogen.…”

Section: Introductionmentioning

confidence: 99%

Emergence of multi-drug resistance Candida auris in Saudi Arabia

Aljindan¹,

AlEraky²,

Mahmoud³

et al. 2020

Preprint

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Background: Candida auris is an emerging multi-drug resistant pathogen with high mortality rate, several cases and nosocomial infections have been reported worldwide causing a major challenge for clinicians and microbiological laboratories. Objectives: The study aim to, describe new cases of C. auris from different sites of infection confirmed by MALDI TOF MS and ribosomal sequencing, develop the phylogenetic analysis of these isolates, detect resistant strains of C. auris to both azole and echinocandin by amplification of ERG11 and FKS1 genes. Methods: A total of six specimens were collected from blood, urine, ear swab and groin screening sample during the period from November 2018 to March 2019. Isolates were incubated for 48 hours on Sabroud agar at 42℃, then confirmed by Matrix-Assisted Laser Desorption/Ionization-Time of Flight mass spectrometry (MALDI-TOF MS). Sequences of 18S rRNA gene from isolates and phylogenetic analysis were performed. Finally, molecular analysis of resistance genes was performed to detect the efficacy of treatment. Results: Clinical isolates were identified by the growth on Sabroud agar at 42℃ and confirmed by MALDI-TOF MS analysis. Evolutionary analyses were conducted in MEGA7 and sequences of 18S rRNA gene were submitted to GenBank. All samples were positive for both ERG11 and FKS1 which confer azole- and echinocandin-resistant strains. Conclusions: This study shed light on a public health threat of an emerging pathogen. Therefore, the hospital implemented strict contact screening and infection control precautions to prevent C. auris infection. Finally, there is a critical need to monitor the antifungal resistance in different geographical areas and implementation of efficient guidelines for treatment.

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“…[12][13][14][15] In Saudi Arabia, 4 cases of Candida auris have been described in 2 isolated case reports from Dammam 16 and Makkah. 17 The common features in the reported cases were long complicated hospital stays that involved intensive care, antibiotic use, surgical procedures, and device insertion. 16,17 Giving the current challenges in laboratory confirmation of Candida auris in many hospitals, 18,19 these 2 reports probably represent the "tip of iceberg" of Candida auris problem in Saudi Arabia.…”

mentioning

confidence: 97%

“…17 The common features in the reported cases were long complicated hospital stays that involved intensive care, antibiotic use, surgical procedures, and device insertion. 16,17 Giving the current challenges in laboratory confirmation of Candida auris in many hospitals, 18,19 these 2 reports probably represent the "tip of iceberg" of Candida auris problem in Saudi Arabia. In response to detection of Candida auris for the first time in our hospital, we conducted an outbreak investigation.…”

mentioning

confidence: 97%

Management ofCandida aurisoutbreak in a tertiary-care setting in Saudi Arabia

Alshamrani

El-Saed

Mohammed

et al. 2020

Infect. Control Hosp. Epidemiol.

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Objective: To describe local experience in managing an outbreak of Candida auris in a tertiary-care setting. Methods: In response to emerging Candida auris, an outbreak investigation was conducted at our hospital between March 2018 and June 2019. Once a patient was confirmed to have Candida auris, screening of exposed patients and healthcare workers (HCWs) was conducted. Postexposure screening included those who had had direct contact with or shared the same unit or ward with a laboratory-confirmed case. In response to the increasing number of cases, new infection control measures were implemented. Results: In total, 23 primary patients were detected over 15 months. Postexposure screening identified 11 more cases, and all were patients. Furthermore, ~28.6% of patients probably caught infection in another hospital or in the community. Infection control measures were strictly implemented including hand hygiene, personal protective equipment, patient hygiene, environmental cleaning, cohorting of patients and HCWs, and avoiding the sharing of equipment. The wave reached a peak in April 2019, followed by a sharp decrease in May 2019 and complete clearance in June 2019. The case patients were equally distributed between intensive care units (51.4%) and wards (48.6%). More infections (62.9%) occurred than colonizations (37.1%). Urinary tract infection (42.9%) and candidemia (17.1%) were the main infections. In total, 7 patients (20.0%) died during hospitalization; among them, 6 (17.1%) died within 30 days of diagnosis. Conclusions: Active screening of exposed patients followed by strict infection control measures, including environmental cleaning, was successful in ending the outbreak. Preventing future outbreaks is challenging due to outside sources of infection and environmental resistance.

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The second confirmed case of Candida auris from Saudi Arabia

Cited by 12 publications

References 6 publications

Update on invasive fungal infections in the Middle Eastern and North African region

Update on invasive fungal infections in the Middle Eastern and North African region

Emergence of multi-drug resistance Candida auris in Saudi Arabia

Management ofCandida aurisoutbreak in a tertiary-care setting in Saudi Arabia

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