Axillary Digital Thermometers uplifted a multidrug-susceptible Candida auris outbreak among COVID-19 patients in Brazil.

Autor: Nobrega de Almeida J Jr; Disciplina de Infectologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.; Central Laboratory Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil., Brandão IB; Comissão de Controle de Infecção Hospitalar, Hospital de Bahia, Salvador, Brazil., Francisco EC; Disciplina de Infectologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil., de Almeida SLR; EpiSUS, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Brazil., de Oliveira Dias P; EpiSUS, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Brazil., Pereira FM; Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador, Brazil., Santos Ferreira F; Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador, Brazil., de Andrade TS; Superintendência de Vigilância e Proteção da Saúde, Secretaria de Saúde do Estado da Bahia, Salvador, Brazil., de Miranda Costa MM; Brazilian Health Regulatory Agency, Ministério da Saúde, Brasília, Brazil., de Souza Jordão RT; CGLAB, Ministério da Saúde, Brasília, Brazil., Meis JF; Department of Medical Microbiology and Infectious Diseases, ECMM Center of Excellence for Medical Mycology, Nijmegen, The Netherlands.; Center of Expertise in Mycology, Radboud University Medical Center/Canisius Wilhelmina Hospital, Nijmegen, The Netherlands., Colombo AL; Disciplina de Infectologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.
Jazyk: angličtina
Zdroj: Mycoses [Mycoses] 2021 Sep; Vol. 64 (9), pp. 1062-1072. Date of Electronic Publication: 2021 Jun 07.
DOI: 10.1111/myc.13320
Abstrakt: Objectives: To describe the first outbreak of Candida auris in Brazil, including epidemiological, clinical and microbiological data.
Methods: After the first Candida auris-colonised patient was diagnosed in a COVID-19 ICU at a hospital in Salvador, Brazil, a multidisciplinary team conducted a local C. auris prevalence investigation. Screening cultures for C. auris were collected from patients, healthcare workers and inanimate surfaces. Risk factors for C. auris colonisation were evaluated, and the fungemia episodes that occurred after the investigation were also analysed and described. Antifungal susceptibility of the C. auris isolates was determined, and they were genotyped with microsatellite analysis.
Results: Among body swabs collected from 47 patients, eight (n = 8/47, 17%) samples from the axillae were positive for C. auris. Among samples collected from inanimate surfaces, digital thermometers had the highest rate of positive cultures (n = 8/47, 17%). Antifungal susceptibility testing showed MICs of 0.5 to 1 mg/L for AMB, 0.03 to 0.06 mg/L for voriconazole, 2 to 4 mg/L for fluconazole and 0.03 to 0.06 mg/L for anidulafungin. Microsatellite analysis revealed that all C. auris isolates belong to the South Asian clade (Clade I) and had different genotypes. In multivariate analysis, having a colonised digital thermometer was the only independent risk factor associated with C. auris colonisation. Three episodes of C. auris fungemia occurred after the investigation, with 30-day attributable mortality of 33.3%.
Conclusions: Emergence of C. auris in Salvador, Brazil, may be related to local C. auris clade I closely related genotypes. Contaminated axillary monitoring thermometers may facilitate the dissemination of C. auris reinforcing the concept that these reusable devices should be carefully cleaned with an effective disinfectant or replaced by other temperature monitoring methods.
(© 2021 Wiley-VCH GmbH.)
Databáze: MEDLINE
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