Abstract
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.
Highlights
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Sequence-Based Identification We identified 40 patient-specific Candida strains as C. haemulonii by the Vitek-2 YST ID system during January 2009–July 2015
9 isolates recovered during May 2014–May 2015 were available for analysis; we identified 6 as C. auris and 3 as C. haemulonii by internal transcribed spacer (ITS) and large subunit (LSU) sequencing (Table 1)
Summary
This activity has been planned and implemented through the joint providership of Medscape, LLC and Emerging Infectious Diseases. LLC designates this Journal-based CME activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)TM. All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: [1] review the learning objectives and author disclosures; [2] study the education content; [3] take the post-test with a 75% minimum passing score and complete the evaluation at http://www.medscape.org/journal/eid; and [4] view/print certificate. Upon completion of this activity, participants will be able to: 1.
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