1. Nationwide Outbreak of Candida auris Infections Driven by COVID-19 Hospitalizations, Israel, 2021-2022
- Author
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Biran R, Cohen R, Finn T, Brosh-Nissimov T, Rahav G, Yahav D, Amit S, Shachor-Meyouhas Y, Atamna A, Bishara J, Ashkenazi-Hoffnung L, Ben Zvi H, Hershman-Sarafov M, Maayan S, Maor Y, Schwartz O, Zimhony O, Lellouche J, Elbaz M, Burdelova E, Mizrahi N, Novikov A, Henig O, and Ben-Ami R
- Subjects
- Humans, Candida genetics, Antifungal Agents pharmacology, Antifungal Agents therapeutic use, Candida auris, Israel epidemiology, Disease Outbreaks, Hospitalization, Microbial Sensitivity Tests, COVID-19 epidemiology, Candidiasis, Invasive drug therapy
- Abstract
We report an outbreak of Candida auris across multiple healthcare facilities in Israel. For the period of May 2014-May 2022, a total of 209 patients with C. auris infection or colonization were identified. The C. auris incidence rate increased 30-fold in 2021 (p = 0.00015), corresponding in time with surges of COVID-19-related hospitalization. Multilocus sequence typing revealed hospital-level outbreaks with distinct clones. A clade III clone, imported into Israel in 2016, accounted for 48.8% of typed isolates after January 2021 and was more frequently resistant to fluconazole (100% vs. 63%; p = 0.00017) and voriconazole (74% vs. 5.2%; p<0.0001) than were non-clade III isolates. A total of 23% of patients had COVID-19, and 78% received mechanical ventilation. At the hospital level, outbreaks initially involved mechanically ventilated patients in specialized COVID-19 units and then spread sequentially to ventilated non-COVID-19 patients and nonventilated patients.
- Published
- 2023
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