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Antimicrobial Resistance and Infection Control

, 5:35

First Online: 19 October 2016Received: 02 September 2016Accepted: 08 September 2016

Abstract

BackgroundCandida 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.

MethodsData 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.

ResultsThis 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.

ConclusionThis 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.

KeywordsCandida auris Outbreak Healthcare-associated infections AFLP Genotyping AbbreviationsAFLPAmplified fragment length polymorphism

BCBlood culture

BDGβ-D-glucan

ICUIntensive care unit

IPCInfection prevention and control

MALDI-TOFMatrix Assisted Laser Desorption Ionization-Time of Flight mass spectrometry

MICMinimal inhibitory concentration

PCRPolymerase chain reaction

UTIUrinary tract infection

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Autor: Silke Schelenz - Ferry Hagen - Johanna L. Rhodes - Alireza Abdolrasouli - Anuradha Chowdhary - Anne Hall - Lisa Ryan - Joa

Fuente: https://link.springer.com/







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