First hospital outbreak of the globally emerging Candida auris in a European hospital
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Author(s)
Type
Journal Article
Abstract
Background: Candida auris is a globally emerging multidrug resistant fungal pathogen causing nosocomial transmission.
We report an ongoing outbreak of C. auris in a London cardio-thoracic center between April 2015 and July 2016. This is
the first report of C. auris in Europe and the largest outbreak so far. We describe the identification, investigation and
implementation of control measures.
Methods: Data on C. auris case demographics, environmental screening, implementation of infection prevention/control
measures, and antifungal susceptibility of patient isolates were prospectively recorded then analysed retrospectively.
Speciation of C. auris was performed by MALDI-TOF and typing of outbreak isolates performed by amplified fragment
length polymorphism (AFLP).
Results: This report describes an ongoing outbreak of 50 C. auris cases over the first 16 month (April 2015 to July 2016)
within a single Hospital Trust in London. A total of 44 % (n = 22/50) patients developed possible or proven C. auris
infection with a candidaemia rate of 18 % (n = 9/50). Environmental sampling showed persistent presence of the yeast
around bed space areas. Implementation of strict infection and prevention control measures included: isolation
of cases and their contacts, wearing of personal protective clothing by health care workers, screening of
patients on affected wards, skin decontamination with chlorhexidine, environmental cleaning with chorine
based reagents and hydrogen peroxide vapour. Genotyping with AFLP demonstrated that C. auris isolates from
the same geographic region clustered.
Conclusion: This ongoing outbreak with genotypically closely related C. auris highlights the importance of
appropriate species identification and rapid detection of cases in order to contain hospital acquired transmission.
We report an ongoing outbreak of C. auris in a London cardio-thoracic center between April 2015 and July 2016. This is
the first report of C. auris in Europe and the largest outbreak so far. We describe the identification, investigation and
implementation of control measures.
Methods: Data on C. auris case demographics, environmental screening, implementation of infection prevention/control
measures, and antifungal susceptibility of patient isolates were prospectively recorded then analysed retrospectively.
Speciation of C. auris was performed by MALDI-TOF and typing of outbreak isolates performed by amplified fragment
length polymorphism (AFLP).
Results: This report describes an ongoing outbreak of 50 C. auris cases over the first 16 month (April 2015 to July 2016)
within a single Hospital Trust in London. A total of 44 % (n = 22/50) patients developed possible or proven C. auris
infection with a candidaemia rate of 18 % (n = 9/50). Environmental sampling showed persistent presence of the yeast
around bed space areas. Implementation of strict infection and prevention control measures included: isolation
of cases and their contacts, wearing of personal protective clothing by health care workers, screening of
patients on affected wards, skin decontamination with chlorhexidine, environmental cleaning with chorine
based reagents and hydrogen peroxide vapour. Genotyping with AFLP demonstrated that C. auris isolates from
the same geographic region clustered.
Conclusion: This ongoing outbreak with genotypically closely related C. auris highlights the importance of
appropriate species identification and rapid detection of cases in order to contain hospital acquired transmission.
Date Issued
2016-10-19
Date Acceptance
2016-09-08
Citation
Antimicrobial Resistance and Infection Control, 2016, 5 (10)
ISSN
2047-2994
Publisher
BioMed Central
Journal / Book Title
Antimicrobial Resistance and Infection Control
Volume
5
Issue
10
Copyright Statement
© 2016 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
License URL
Subjects
Science & Technology
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
Infectious Diseases
Microbiology
Pharmacology & Pharmacy
Candida auris
Outbreak
Healthcare-associated infections
AFLP Genotyping
DESORPTION IONIZATION-TIME
FLIGHT MASS-SPECTROMETRY
ANTIFUNGAL SUSCEPTIBILITY
CLONAL STRAIN
INDIA
IDENTIFICATION
HAEMULONII
AFLP Genotyping
Candida auris
Healthcare-associated infections
Outbreak
0605 Microbiology
1103 Clinical Sciences
1108 Medical Microbiology
Publication Status
Published
Article Number
ARTN 35