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BackgroundEnvironmental contamination is suspected to play an important role in Candida auris transmission. Understanding speed and risks of contamination after room disinfection could inform environmental cleaning recommendations.MethodsWe conducted a prospective multicenter study of environmental contamination associated with C. auris colonization at six ventilator-capable skilled nursing facilities and one acute-care hospital in Illinois and California. Known C. auris carriers were sampled at five body-sites followed by sampling of nearby room surfaces before disinfection and at 0, 4, 8, and 12-hours post-disinfection. Samples were cultured for C. auris and bacterial multidrug-resistant organisms (MDROs). Odds of surface contamination after disinfection were analyzed using multilevel generalized estimating equations.ResultsAmong 41 known C. auris carriers, colonization was detected most frequently on palms/fingertips (76%) and nares (71%). C. auris contamination was detected on 32.2% (66/205) of room surfaces pre-disinfection and 20.5% (39/190) of room surfaces by 4-hours post-disinfection. A higher number of C. auris-colonized body sites was associated with higher odds of environmental contamination at every time point following disinfection, adjusting for facility of residence. In the rooms of 38 (93%) C. auris carriers co-colonized with a bacterial MDRO, 2%-24% of surfaces were additionally contaminated with the same MDRO by 4-hours post-disinfection.ConclusionsC. auris can contaminate the healthcare environment rapidly after disinfection, highlighting the challenges associated with environmental disinfection. Future research should investigate long-acting disinfectants, antimicrobial surfaces, and more effective patient skin antisepsis to reduce the environmental reservoir of C. auris and bacterial MDROs in healthcare settings.

Sporotrichosis, an implantation mycosis caused by fungi in the genus Sporothrix, affects humans and other mammals. Although cat-transmitted sporotrichosis caused by the highly transmissible Sporothrix brasiliensis species is an increasing [...]

[This corrects the article DOI: 10.1017/ash.2022.205.].

Candida auris is a fungal pathogen of high concern due to its ability to cause healthcare-associated infections and outbreaks, its resistance to antimicrobials and disinfectants and its persistence on human skin and in the inanimate environment. To inform surveillance and future mitigation strategies, we defined the extent of skin colonization and explored the microbiome associated with C. auris colonization. We collected swab specimens and clinical data at three times points between January and April 2019 from 57 residents (up to ten body sites each) of a ventilator-capable skilled nursing facility with endemic C. auris and routine chlorhexidine gluconate (CHG) bathing. Integrating microbial-genomic and epidemiologic data revealed occult C. auris colonization of multiple body sites not targeted commonly for screening. High concentrations of CHG were associated with suppression of C. auris growth but not with deleterious perturbation of commensal microbes. Modeling human mycobiome dynamics provided insight into underlying alterations to the skin fungal community as a possible modifiable risk factor for acquisition and persistence of C. auris. Failure to detect the extensive, disparate niches of C. auris colonization may reduce the effectiveness of infection-prevention measures that target colonized residents, highlighting the importance of universal strategies to reduce C. auris transmission. Longitudinal skin site sampling of residents in a skilled nursing facility sheds light on persistent niches of the emerging fungal pathogen Candida auris., Author(s): Diana M. Proctor [sup.1] , Thelma Dangana [sup.2] , D. Joseph Sexton [sup.3] , Christine Fukuda [sup.2] , Rachel D. Yelin [sup.2] , Mary Stanley [sup.2] , Pamela B. [...]

Several single-nucleotide polymorphism (SNP) genome-wide association studies (GWASs) have been completed in multiple sclerosis (MS). Follow-up studies of the variants with the most promising rankings, especially when supplemented by informed candidate gene selection, have proven to be extremely successful. In this study we report the results of a multi-stage replication analysis of the putatively associated SNPs identified in the Wellcome Trust Case Control Consortium non-synonymous SNP (nsSNP) screen. In total, the replication sample consisted of 3444 patients and 2595 controls. A combined analysis of the nsSNP screen and replication data provides evidence implicating a novel additional locus, rs3748816 in membrane metalloendopeptidase-like 1 (MMEL1; odds ratio=1.16, P=3.54 × 10⁻⁶) in MS susceptibility.

We develop a statistical method to assess CMIP6 simulations of large-scale surface temperature change during the historical period (1850–2014), considering all time scales, allowing for the different unforced variability of each model and the observations, observational uncertainty, and variable ensemble size. The generality of this method, and the fact that it incorporates information about the unforced variability, makes it a useful model assessment tool. We apply this method to the historical simulations of the CMIP6 multimodel ensemble. We use three indices that measure different aspects of large-scale surface air temperature change: global mean, hemispheric gradient, and a recently developed index that captures the sea surface temperature (SST) pattern in the tropics (SST#; see Fueglistaler and Silvers). We use the following observations: HadCRUT5 for the first two indices, and AMIPII and ERSSTv5 for SST#. In each case, we test the hypothesis that the model's forced response is compatible with the observations, accounting for unforced variability in both models and observations as well as measurement uncertainty. This hypothesis is accepted more often (75% of the models) for the hemispheric gradient than for the global mean, for which half of the models fail the test. The tropical SST pattern is poorly simulated in all models. Given that the tropical SST pattern can strongly modulate the relationship between energy imbalance and global-mean surface temperature anomalies on annual to decadal time scales (short-term feedback parameter), we suggest this should be a focus area for future improvements due to its potential implications for the global-mean temperature evolution in decadal time scales. [ABSTRACT FROM AUTHOR]