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Ongoing Challenges with Healthcare-Associated Candida auris Outbreaks in Oman

Authors: Amal Al Maani; Hema Paul; Azza Al-Rashdi; Adil Al Wahaibi; Amina Al-Jardani; Asma M Ali Al Abri; Mariam A H AlBalushi; +7 Authors

Ongoing Challenges with Healthcare-Associated Candida auris Outbreaks in Oman

Abstract

s cohort was 53.1. Two swabs collected from a ventilator in two different beds in the ICU were positive for C. auris. None of the health care worker samples were positive. Molecular typing showed that clinical and environmental isolates were genetically similar and all belonged to the South Asian C. auris clade I. Most isolates had non-susceptible fluconazole (100%) and amphotericin B (33%) minimal inhibitory concentrations (MICs), but had low echinocandin and voriconazole MICs. Despite multimodal infection prevention and control measures, new cases continued to appear, challenging all the containment efforts.

Candida auris has emerged in the past decade as a multi-drug resistant public health threat causing health care outbreaks. Here we report epidemiological, clinical, and microbiological investigations of a C. auris outbreak in a regional Omani hospital between April 2018 and April 2019. The outbreak started in the intensive care areas (intensive care unit (ICU), coronary care unit (CCU), and high dependency unit) but cases were subsequently diagnosed in other medical and surgical units. In addition to the patients&rsquo

clinical and screening samples, environmental swabs from high touch areas and from the hands of 35 staff were collected. All the positive samples from patients and environmental screening were confirmed using MALDI-TOF, and additional ITS-rDNA sequencing was done for ten clinical and two environmental isolates. There were 32 patients positive for C. auris of which 14 (43.8%) had urinary tract infection, 11 (34.4%) had candidemia, and 7 (21.8%) had asymptomatic skin colonization. The median age was 64 years (14&ndash

88) with 17 (53.1%) male and 15 (46.9%) female patients. Prior to diagnosis, 21 (65.6%) had been admitted to the intensive care unit, and 11 (34.4%) had been nursed in medical or surgical wards. The crude mortality rate in our patient&rsquo

Country
Netherlands
Subjects by Vocabulary

Microsoft Academic Graph classification: medicine.medical_specialty law.invention law Intensive care Internal medicine Epidemiology medicine Infection control business.industry Mortality rate Outbreak Intensive care unit Candida auris Coronary care unit business

Library of Congress Subject Headings: lcsh:QH301-705.5 lcsh:Biology (General)

Keywords

Microbiology (medical), Oman, QH301-705.5, Plant Science, Article, All institutes and research themes of the Radboud University Medical Center, Biology (General), Ecology, Evolution, Behavior and Systematics, outbreak, Sohar Hospital, Candida auris, infection, <i>candida auris</i>, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], Radboudumc 4: lnfectious Diseases and Global Health RIHS: Radboud Institute for Health Sciences

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  • citations
    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    39
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Top 10%
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 10%
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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
39
Top 10%
Top 10%
Top 10%
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gold