Molecular Epidemiology of Candida auris in Colombia Reveals a Highly Related, Countrywide Colonization With Regional Patterns in Amphotericin B Resistance
Open accessAbstract
Background: Candida auris is a multidrug-resistant yeast associated with hospital outbreaks worldwide. During 2015–2016, multiple outbreaks were reported in Colombia. We aimed to understand the extent of contamination in healthcare settings and to characterize the molecular epidemiology of C. auris in Colombia. Methods: We sampled patients, patient contacts, healthcare workers, and the environment in 4 hospitals with recent C. auris outbreaks. Using standardized protocols, people were swabbed at different body sites. Patient and procedure rooms were sectioned into 4 zones and surfaces were swabbed. We performed whole-genome sequencing (WGS) and antifungal susceptibility testing (AFST) on all isolates. Results: Seven of the 17 (41%) people swabbed were found to be colonized. Candida auris was isolated from 37 of 322 (11%) environmental samples. These were collected from a variety of items in all 4 zones. WGS and AFST revealed that although isolates were similar throughout the country, isolates from the northern region were genetically distinct and more resistant to amphotericin B (AmB) than the isolates from central Colombia. Four novel nonsynonymous mutations were found to be significantly associated with AmB resistance. Conclusions: Our results show that extensive C. auris contamination can occur and highlight the importance of adherence to appropriate infection control practices and disinfection strategies. Observed genetic diversity supports healthcare transmission and a recent expansion of C. auris within Colombia with divergent AmB susceptibility.
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Fluconazole-resistant Candida auris isolates with no mutation in ERG11 have been described.
“as have fluconazole-resistant isolates of C. auris with no mutation in ERG11”
From Mutations in <i>TAC1B</i> : a Novel Genetic Determinant of Clinical Fluconazole Resistance in Candida auris (2020) · cites this paper as [14]
There are yet-to-be-identified mechanisms of fluconazole resistance in Candida auris.
“suggesting the presence of yet-to-be-identified mechanisms of fluconazole resistance (8, 14).”
From Mutations in <i>TAC1B</i> : a Novel Genetic Determinant of Clinical Fluconazole Resistance in Candida auris (2020) · cites this paper as [14]
Clinical isolates harboring the same ERG11 mutations and exhibiting a fluconazole MIC as low as 1 mg/liter have been described.
“clinical isolates harboring the same ERG11 mutations and exhibiting a fluconazole MIC as low as 1 mg/liter have been described previously”
From Mutations in <i>TAC1B</i> : a Novel Genetic Determinant of Clinical Fluconazole Resistance in Candida auris (2020) · cites this paper as [14]
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- Authors
- Escandón, P., Chow, N. A., Caceres, D. H., Gade, L., Berkow, E. L., Armstrong, P., Rivera, S., Misas, E., Duarte, C., Moulton-Meissner, H., Welsh, R. M., Parra, C., Pescador, L. A., Villalobos, N., Salcedo, S., Berrio, I., Varón, C., Espinosa-Bode, A., Lockhart, S. R., Jackson, B. R., Litvintseva, A. P., Beltran, M., & Chiller, T. M.
- Affiliations
- Instituto Nacional de Salud (CO)
- Centers for Disease Control and Prevention (US)
- Universidad de Antioquia (CO)
- Unidad de Investigación en Proteómica y Micosis Humanas, Facultad de Ciencias, Pontificia Universidad Javeriana
- Hospital Militar Central (CO)
- Clínica Los Nogales, Bogotá
- Clínica General del Norte, Barranquilla
- Grupo de Micología Médica y Experimental, Corporación para Investigaciones Biológicas
- Fundación Unidad de Cuidados Intensivos Doña Pilar, Cartagena, Colombia
- Instituto Nacional de Salud, Bogotá, Colombia
- Corresponding author
- Chow, Nancy A
- ORCID
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-05-16
- Volume
- 68
- Issue
- 1
- Pages
- 15-21
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2804122276
- Cited by
- 222
- References
- 20
- Citations by year
- 2026: 19 · 2025: 23 · 2024: 26 · 2023: 32 · 2022: 15 · 2021: 31 · 2020: 37 · 2019: 30 · 2018: 9
- FWCI
- 20.20
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- cc-by-nc-nd
- Locations
- Clinical Infectious Diseases (publishedVersion, public-domain)
- PubMed (publishedVersion)
- Institutional Repository University of Antioquia (University of Antioquia) (publishedVersion, cc-by-nc-nd)
- Funders
- Instituto Nacional de Salud
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Yeasts and Rust Fungi Studies
- Keywords
- Candida auris, molecular epidemiology, amphotericin B resistance, hospital outbreak, environmental contamination, nosocomial transmission, genetic diversity, non-synonymous mutations, antifungal susceptibility, infection control, Colombia
- MeSH terms
- Whole Genome Sequencing, Amphotericin B, Antifungal Agents, Candida, Candidiasis, Carrier State, Colombia, Environmental Microbiology, Humans, Microbial Sensitivity Tests, Mycological Typing Techniques, Molecular Epidemiology, Drug Resistance, Fungal, Molecular Typing
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