RESUMO
A Candida auris outbreak has been ongoing in Southern Nevada since August 2021. In this manuscript we describe the sequencing of over 200 C. auris isolates from patients at several facilities. Genetically distinct subgroups of C. auris were detected from Clade I (3 distinct lineages) and III (1 lineage). Open-source bioinformatic tools were developed and implemented to aid in the epidemiological investigation. The work herein compares three methods for C. auris whole genome analysis: Nullarbor, MycoSNP and a new pipeline TheiaEuk. We also describe a novel analysis method focused on elucidating phylogenetic linkages between isolates within an ongoing outbreak. Moreover, this study places the ongoing outbreaks in a global context utilizing existing sequences provided worldwide. Lastly, we describe how the generated results were communicated to the epidemiologists and infection control to generate public health interventions.
Assuntos
Candidíase , Surtos de Doenças , Humanos , Nevada/epidemiologia , Candida auris/genética , Candidíase/epidemiologia , Filogenia , Sequenciamento Completo do Genoma , Genoma Fúngico , Polimorfismo de Nucleotídeo Único , Testes de Sensibilidade Microbiana , Biologia ComputacionalRESUMO
Candida auris transmission is steadily increasing across the United States. We report culture-based detection of C. auris in wastewater and the epidemiologic link between isolated strains and southern Nevada, USA, hospitals within the sampled sewershed. Our results illustrate the potential of wastewater surveillance for containing C. auris.
Assuntos
Candida , Candidíase , Humanos , Estados Unidos/epidemiologia , Candidíase/tratamento farmacológico , Candida auris , Águas Residuárias , Nevada/epidemiologia , Vigilância Epidemiológica Baseada em Águas Residuárias , Surtos de Doenças , Antifúngicos/uso terapêuticoRESUMO
Health disparity refers to systematic differences in health outcomes between groups and communities based on socioeconomic isolation. In the USA, health disparities among minority groups, especially African Americans, limit their access to quality medical care and other beneficial resources and services. Presently, the novel coronavirus (COVID-19) highlights the extreme healthcare challenges that exist in the African American and other minority communities in the USA. African Americans are dying at a rate nearly four times higher than the national average. With inadequate access to quality healthcare, viable resources, and information, COVID-19 will continue to have a disastrous effect on African American communities. This communication provides a brief overview of the health inequalities resulting in African Americans dying disproportionately during the COVID-19 pandemic.
Assuntos
Negro ou Afro-Americano , COVID-19/etnologia , Acessibilidade aos Serviços de Saúde , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde , Grupos Minoritários , Qualidade da Assistência à Saúde , Acesso à Informação , COVID-19/mortalidade , COVID-19/terapia , COVID-19/virologia , Coronavirus , Etnicidade , Humanos , Pandemias , Grupos Raciais , SARS-CoV-2 , Fatores Socioeconômicos , Estados Unidos/epidemiologiaRESUMO
We describe transmission of Klebsiella pneumoniae carbapenemase-producing Escherichia coli sequence type (ST) 1193 in a group home. E. coli ST1193 is an emerging multidrug-resistant clone not previously shown to carry carbapenemases in the United States. Our investigation illustrates the potential of residential group homes to amplify rare combinations of pathogens and resistance mechanisms.
