ABSTRACT
Background: Reports of fluconazole-resistant Candida parapsilosis bloodstream infections are increasing. We describe a cluster of fluconazole-resistant C parapsilosis bloodstream infections identified in 2021 on routine surveillance by the Georgia Emerging Infections Program in conjunction with the Centers for Disease Control and Prevention. Methods: Whole-genome sequencing was used to analyze C parapsilosis bloodstream infections isolates. Epidemiological data were obtained from medical records. A social network analysis was conducted using Georgia Hospital Discharge Data. Results: Twenty fluconazole-resistant isolates were identified in 2021, representing the largest proportion (34%) of fluconazole-resistant C parapsilosis bloodstream infections identified in Georgia since surveillance began in 2008. All resistant isolates were closely genetically related and contained the Y132F mutation in the ERG11 gene. Patients with fluconazole-resistant isolates were more likely to have resided at long-term acute care hospitals compared with patients with susceptible isolates (P = .01). There was a trend toward increased mechanical ventilation and prior azole use in patients with fluconazole-resistant isolates. Social network analysis revealed that patients with fluconazole-resistant isolates interfaced with a distinct set of healthcare facilities centered around 2 long-term acute care hospitals compared with patients with susceptible isolates. Conclusions: Whole-genome sequencing results showing that fluconazole-resistant C parapsilosis isolates from Georgia surveillance demonstrated low genetic diversity compared with susceptible isolates and their association with a facility network centered around 2 long-term acute care hospitals suggests clonal spread of fluconazole-resistant C parapsilosis. Further studies are needed to better understand the sudden emergence and transmission of fluconazole-resistant C parapsilosis.
ABSTRACT
We investigated an increase in Trichosporon asahii isolates among inpatients. We identified 63 cases; 4 involved disseminated disease. Trichosporon species was recovered from equipment cleaning rooms, washbasins, and fomites, which suggests transmission through washbasins. Patient washbasins should be single-patient use only; adherence to appropriate hospital disinfection guidelines was recommended.
Subject(s)
Cross Infection/microbiology , Disinfection/standards , Intensive Care Units/standards , Trichosporon/isolation & purification , Trichosporonosis/microbiology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Cross Infection/diagnosis , Cross Infection/prevention & control , Equipment Contamination , Female , Fomites/microbiology , Guideline Adherence , Guidelines as Topic , Humans , Jamaica , Male , Middle Aged , Trichosporon/genetics , Trichosporonosis/diagnosis , Trichosporonosis/prevention & control , Young AdultABSTRACT
The proinflammatory cytokines TNF-alpha and IL-6 are important inflammatory mediators that may be regulated by circadian rhythms. However, the production and detection of these cytokines have not been examined in the degu, a diurnal species used in some studies of circadian rhythms. In this study, we used bioassays to attempt to measure tumor necrosis factor (TNF-alpha) and interleukin 6 (IL-6) levels in degus exposed to an inflammatory stimulus, lipopolysaccharide (LPS). In an in vitro study, whole blood was incubated with LPS. After 6 and 24 h of LPS stimulation, TNF-alpha levels were substantially increased. However, IL-6 was not found in any of the samples. In an in vivo study, LPS was given to degus intraperitoneally. Similar to responses seen in other species, LPS stimulation resulted in marked neutrophil recruitment into the peritoneal space but not the alveolar space. TNF-alpha was present in large amounts in plasma and/or peritoneal lavage fluid. Again, IL-6 was not detectable with the bioassay. These findings suggest that degus do not produce IL-6, that they produce IL-6 in extremely small amounts, or that the bioassay is unable to detect IL-6 from degus. In conclusion, using well-established models of acute inflammation, this study demonstrated that TNF-alpha, but not IL-6, could be detected in plasma and peritoneal lavage fluids from degus with standard bioassays used for cytokine detection in other species.
