ABSTRACT
A patient transferred from South Africa to Israel acquired a Candida auris infection. Phylogenetic analysis showed resemblance of C. auris to isolates from South Africa but not Israel, suggesting travel-associated infection. C. auris infection occurred weeks later in another patient at the same hospital, suggesting prolonged environmental persistence.
Subject(s)
Candida , Candidiasis/epidemiology , Candidiasis/transmission , Cross Infection/epidemiology , Cross Infection/transmission , Disease Outbreaks , Adult , Aged , Antifungal Agents/pharmacology , Candida/classification , Candida/genetics , Candidiasis/history , Candidiasis/microbiology , Cross Infection/history , Cross Infection/microbiology , History, 21st Century , Humans , Israel/epidemiology , Male , Microbial Sensitivity Tests , Middle Aged , Phylogeny , PhylogeographyABSTRACT
Candida auris and C. haemulonii are closely related, multidrug-resistant emerging fungal pathogens that are not readily distinguishable with phenotypic assays. We studied C. auris and C. haemulonii clinical isolates from 2 hospitals in central Israel. C. auris was isolated in 5 patients with nosocomial bloodstream infection, and C. haemulonii was found as a colonizer of leg wounds at a peripheral vascular disease clinic. Liberal use of topical miconazole and close contact among patients were implicated in C. haemulonii transmission. C. auris exhibited higher thermotolerance, virulence in a mouse infection model, and ATP-dependent drug efflux activity than C. haemulonii. Comparison of ribosomal DNA sequences found that C. auris strains from Israel were phylogenetically distinct from isolates from East Asia, South Africa and Kuwait, whereas C. haemulonii strains from different countries were closely interrelated. Our findings highlight the pathogenicity of C. auris and underscore the need to limit its spread.
