• Clin. Infect. Dis. · Jan 2019

    Molecular Epidemiology of Candida auris in Colombia Reveals a Highly Related, Countrywide Colonization With Regional Patterns in Amphotericin B Resistance.

    • Patricia Escandón, Nancy A Chow, Diego H Caceres, Lalitha Gade, Elizabeth L Berkow, Paige Armstrong, Sandra Rivera, Elizabeth Misas, Carolina Duarte, Heather Moulton-Meissner, Rory M Welsh, Claudia Parra, Luz Angela Pescador, Nohora Villalobos, Soraya Salcedo, Indira Berrio, Carmen Varón, Andrés Espinosa-Bode, Shawn R Lockhart, Brendan R Jackson, Anastasia P Litvintseva, Mauricio Beltran, and Tom M Chiller.
    • Instituto Nacional de Salud, Bogotá, Colombia.
    • Clin. Infect. Dis. 2019 Jan 1; 68 (1): 15-21.

    BackgroundCandida 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.MethodsWe 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.ResultsSeven 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.ConclusionsOur 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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