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  4. Genomic epidemiology of the UK outbreak of the emerging human fungal pathogen Candida auris
 
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Genomic epidemiology of the UK outbreak of the emerging human fungal pathogen Candida auris
File(s)
s41426-018-0045-x.pdf (730.42 KB)
Published version
Author(s)
Rhodes, JL
Abdolrasouli, Alireza
Farrer, Rhys
Cuomo, Christina
Aanensen, David
more
Type
Journal Article
Abstract
Candida auris was first described in 2009, and has since caused nosocomial outbreaks, invasive infections and fungaemia across at least 19 countries in five continents. An outbreak of C. auris occurred in a specialised cardiothoracic London hospital between April 2015 and November 2016, which to date has been the largest outbreak within the UK, involving a total of 72 patients. To understand the genetic epidemiology of C. auris infection, both within this hospital and within a global context, we sequenced the outbreak isolate genomes using Oxford Nanopore Technologies and Illumina to detect antifungal resistance alleles and to reannotate the C. auris genome. Phylogenomic analysis placed the UK outbreak in the India/Pakistan clade, demonstrating an Asian origin: the outbreak showed similar genetic diversity to that of the entire clade and limited local spatiotemporal clustering was observed. One isolate displayed resistance to both echinocandins and 5-flucytosine; the former was associated with a serine to tyrosine amino acid substitution in the gene FKS1, and the latter was associated with a phenylalanine to isoleucine substitution in the gene FUR1. These mutations add to a growing body of research on multiple antifungal drug targets in this organism. Multiple differential episodic selection of antifungal resistant genotypes has occurred within a genetically heterogenous population across this outbreak, creating a resilient pathogen and making it difficult to define local-scale patterns of transmission as well as implementing outbreak control measures.
Date Issued
2018-03-29
Date Acceptance
2018-01-25
Citation
Emerging Microbes and Infections, 2018, 7
URI
http://hdl.handle.net/10044/1/56655
DOI
https://www.dx.doi.org/10.1038/s41426-018-0045-x
ISSN
2222-1751
Publisher
Nature Publishing Group
Journal / Book Title
Emerging Microbes and Infections
Volume
7
Copyright Statement
© The Author(s) 2018. This article is licensed under a Creative Commons Attribution 4.0 Internat
ional License, which permits use, sharing, adaptation, distribution and
reproduction
in any medium or format, as long as you give appropriate credit to the origina
l author(s) and the source, provide a li
nktotheCreativeC
ommons license,
and indicate if
changes were made. The images or other third party material in this article are included in the article
’
s Creative Commons license, unless indicated
otherwise in a credit line to the material. If
material is not included in the article
’
s Creative Commons license and your intended use is not permitted by sta
tutory regulation or exceeds the permitted use, you will need to obtain
permission directly from the copyright hol
der. To view a copy of this license, visit
http://creativecommons
.org/licenses/by/4.0/
Sponsor
Medical Research Council (MRC)
Wellcome Trust
Grant Number
MR/K000373/1
105603/Z/14/Z
Subjects
Science & Technology
Life Sciences & Biomedicine
Immunology
Microbiology
FLUCYTOSINE RESISTANCE
POPULATION GENOMICS
NOSOCOMIAL FUNGEMIA
PROTEIN FAMILIES
SEQUENCING DATA
REAL-TIME
RNA GENES
MECHANISMS
DATABASE
MENINGITIS
Publication Status
Published
Article Number
43
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