Germs

Candida auris (Candidozyma auris) is an emerging healthcare-associated yeast that requires rapid identification and infection prevention and control (IPC) action in intensive care units (ICUs). We retrospectively described six C. auris-positive adults detected in a Romanian tertiary-hospital ICU between April and June 2025 using routine clinical, microbiological, screening, and IPC records. The outbreak was operationally defined as two or more epidemiologically linked cases with no prior hospital endemicity; active contact screening encompassed all 24 ICU module patients (42 screening encounters using composite axillary/inguinal swabs). Two patients had candidemia (one following screening-detected colonization), and four had colonization without invasive disease. Identification used MALDI-TOF MS; broth microdilution MICs showed fluconazole resistance (>128 mg/L) in both candidemia isolates. IPC measures included isolation, contact precautions, dedicated equipment, enhanced cleaning, and daily 4% chlorhexidine bathing. All six patients died in hospital; deaths are reported as all-cause, as attribution to C. auris was not possible. This single-center cluster expands Romanian experience but highlights the need for prospective denominators and molecular typing.

Background: Molecular typing data for Candida albicans from Bangladesh remain limited. Materials and Methods: This single-center descriptive study characterized 46 C. albicans isolates collected at Mymensingh Medical College Hospital during three sampling periods between 2021 and 2024. Forty-four isolates were recovered from patients with vulvovaginal candidiasis and two from neonatal bloodstream infections. Diploid sequence types (DSTs) were assigned using the consensus seven-locus multilocus sequence typing scheme, and their allelic and sequence relationships were explored using network and phylogenetic analyses. Results: Forty-two DSTs were identified, of which 41 had not previously been recorded in the PubMLST database. Six DSTs were related to selected established clonal complexes, while DST4161 grouped with clade 13. Using a study-specific network definition based on connections involving differences at no more than three loci, 30 of 42 DSTs, representing 34 of 46 isolates, were distributed across five connected groups. The largest group comprised 16 DSTs and 20 isolates but also included profiles related to four established clonal complexes. Conclusions: These findings document substantial, previously unrecorded allelic diversity among C. albicans isolates sampled at a single hospital in Bangladesh. Broader and systematically sampled studies are required to determine whether the observed profiles represent locally enriched lineages and to assess their clinical or epidemiological significance.

Background: Clostridioides difficile infection (CDI) in liver transplant (LT) recipients often occurs during complex postoperative care. We compared clinical characteristics and total hospital length of stay (LOS) between LT-CDI and non-LT CDI records. Materials and Methods: We analyzed 562 CDI-associated hospital records from 2014 to 2024 (35 LT-CDI; 527 non-LT CDI). The primary endpoint was total hospital LOS; LOS > 30 days was the main secondary endpoint, and >60 and >90 days were post hoc exploratory thresholds for very prolonged stays. LOS was available in 35 LT-CDI and 521 non-LT records. Results: Median LOS was 59 versus 20 days. The crude median difference was 39.0 days (95% CI, 7.0 to 64.0), and the care/antimicrobial-adjusted difference was 28.5 days (95% CI, 0.5 to 50.3). Median LT-to-CDI time was 13 days [IQR, 7 to 36; n = 34]; in 25/35 records (71.4%), infection occurred within 30 days. The adjusted RR for LOS > 30 days was 1.15 (95% CI, 0.85 to 1.55); exploratory RRs were 2.33 (95% CI, 1.45 to 3.73) for >60 days and 2.28 (95% CI, 1.11 to 4.67) for >90 days. Conclusions: LT-CDI records had longer total LOS, clustered early after transplantation, and had a clinically complex course. These findings provide a same-center benchmark for overall hospitalization burden among CDI records by transplant status; estimating CDI-attributable LOS would require an LT group without CDI.