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      Isolation of Candida auris from Ear of Otherwise Healthy Patient, Austria, 2018

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          Abstract

          The emerging pathogen Candida auris is isolated mostly from hospitalized patients and often shows multidrug resistance. We report on the isolation of this yeast in Austria from an outpatient’s auditory canal. The isolate showed good susceptibility against antifungals except for echinocandins; the patient was treated successfully with topical administration of nystatin.

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          First hospital outbreak of the globally emerging Candida auris in a European hospital

          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.
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            Candida auris: a Review of the Literature

            The emerging pathogen Candida auris has been associated with nosocomial outbreaks on five continents. Genetic analysis indicates the simultaneous emergence of separate clades of this organism in different geographical locations. Invasive infection and colonization have been detected predominantly in patients in high-dependency settings and have garnered attention due to variable antifungal resistance profiles and transmission within units instituting a range of infection prevention and control measures. Issues with the identification of C. auris using both phenotypic and molecular techniques have raised concerns about detecting the true scale of the problem. This review considers the literature available on C. auris and highlights the key unknowns, which will provide direction for further work in this field.
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              Author and article information

              Journal
              Emerg Infect Dis
              Emerging Infect. Dis
              EID
              Emerging Infectious Diseases
              Centers for Disease Control and Prevention
              1080-6040
              1080-6059
              August 2018
              : 24
              : 8
              : 1596-1597
              Affiliations
              [1]AGES–Austrian Agency for Health and Food Safety, Graz, Austria (S. Pekard-Amenitsch, A. Schriebl);
              [2]Private otorhinolaryngology practice, Graz (W. Posawetz);
              [3]Medical University of Vienna, Vienna, Austria (B. Willinger);
              [4]Medical University Graz, Graz (B. Kölli, W. Buzina)
              Author notes
              Address for correspondence: Walter Buzina, Medical University Graz, D&R Institute of Hygiene, Microbiology and Environmental Medicine, Neue Stiftingtalstrasse 6, A-8010 Graz, Austria; email: walter.buzina@ 123456medunigraz.at
              Article
              18-0495
              10.3201/eid2408.180495
              6056136
              30016243
              717a283a-60d6-4776-81d7-1903128883d7
              History
              Categories
              Research Letter
              Research Letter
              Isolation of Candida auris from Ear of Otherwise Healthy Patient, Austria, 2018

              Infectious disease & Microbiology
              candida auris,otitis externa,emerging yeast,austria,yeast,fungi
              Infectious disease & Microbiology
              candida auris, otitis externa, emerging yeast, austria, yeast, fungi

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