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Candida auris fungaemia outbreak in a tertiary care academic hospital and emergence of a pan-echinocandin resistant isolate, Greece, 2021 to 2023
- Joseph Meletiadis1 , Maria Siopi1 , Bram Spruijtenburg2,3 , Panagiota-Christina Georgiou1 , Maria Kostoula4 , Sophia Vourli1,5 , Frantzeska Frantzeskaki 6 , Elisabeth Paramythiotou7 , Jacques F Meis3,8 , Iraklis Tsangaris6 , Spyros Pournaras 1
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View Affiliations Hide AffiliationsAffiliations: 1 Clinical Microbiology Laboratory, “Attikon” University General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece 2 Canisius-Wilhelmina Hospital (CWZ)/Dicoon, Nijmegen, The Netherlands 3 Radboudumc-CWZ Center of Expertise for Mycology, Nijmegen, The Netherlands 4 Infection Control Committee, “Attikon” University General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece 5 Institute of Biosciences and Applications, National Centre for Scientific Research "Demokritos", Aghia Paraskevi, Greece 6 Second Critical Care Department, “Attikon” University General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece 7 Department of Critical Care, Laikon Hospital, 11527 Athens, Greece 8 Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD) and Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, GermanyJoseph Meletiadisjmeletiadis med.uoa.gr
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Citation style for this article: Meletiadis Joseph, Siopi Maria, Spruijtenburg Bram, Georgiou Panagiota-Christina, Kostoula Maria, Vourli Sophia, Frantzeskaki Frantzeska, Paramythiotou Elisabeth, Meis Jacques F, Tsangaris Iraklis, Pournaras Spyros. Candida auris fungaemia outbreak in a tertiary care academic hospital and emergence of a pan-echinocandin resistant isolate, Greece, 2021 to 2023. Euro Surveill. 2024;29(45):pii=2400128. https://doi.org/10.2807/1560-7917.ES.2024.29.45.2400128 Received: 24 Feb 2024; Accepted: 29 May 2024
Abstract
After the start of the COVID-19 pandemic, a rapid rise in reported numbers and wide geographic spread of Candida auris-related invasive infections has been observed globally. However, the contemporary epidemiology of C. auris fungaemias in Greece remains unknown. An outbreak of C. auris bloodstream infections has been ongoing for almost 3 years in a Greek tertiary care academic hospital, with 89 C. auris-driven episodes appearing in five waves every 6–7 months following peaks in colonisation rates by 3–4 months. All isolates clustered in clade I and were genetically related, 84% were fluconazole-resistant and all were non-resistant to amphotericin B and echinocandins, except one pan-echinocandin-resistant isolate (FKS1S639F mutant) recovered from a patient on empiric therapy with anidulafungin. Notably, C. auris was in 2023 the most prevalent (34%) cause of candidaemia in our hospital. The accelerated and long-term transmission dynamics of C. auris fungaemia underscore the need for rigorous infection control measures, while antifungal stewardship is warranted to contain the selection of echinocandin-resistant isolates.
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