Special Issue "Candida auris"

A special issue of Journal of Fungi (ISSN 2309-608X).

Deadline for manuscript submissions: closed (31 August 2019).

Special Issue Editors

Guest Editor
Dr. Jacques F. Meis Website E-Mail
Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital (CWZ), 6532 Nijmegen, The Netherlands
Interests: Candida, Candida auris, Drug Resistance Fungal, Emerging Fungal Diseases
Guest Editor
Dr. Anuradha Chowdhary Website E-Mail
Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi 110021, India
Interests: Candida, Candida auris, Medical Mycology, Fungal Biology, Medical Microbiology

Special Issue Information

Dear Colleagues,

This year marks the 10th anniversary of the first formal description of Candida auris, isolated from the external ear of a Japanese patient in 2009. Retrospective studies of culture collections of yeasts from before 2009 only showed single isolates from Korea in 1996 (the earliest known isolate to date) and from Pakistan in 2008. In a relatively short period, C. auris was able to spread all over the world, mainly in hospitals, being reported now from six continents and more than 35 countries. Several countries have reported persistent problems and prolonged outbreaks in healthcare facilities. Unlike other Candida spp., C. auris seems to colonize the skin of patients and can contaminate hospital environments.

C. auris is easily transmitted in healthcare settings and is the first fungus to behave like an epidemic nosocomial bacterial pathogen. Transmission within and between hospitals and nursing home facilities confronts us with major infection control challenges, prompting authorities in the US to declare colonization or infection with C. auris from 2019 onwards a notifiable disease. More than 90% of C. auris isolates are fluconazole resistant, with some rare isolates also being resistant to all three major antifungal classes, leaving no treatment options. A major explanation for the quick worldwide spread was that C. auris is often misidentified as other Candida spp., notably C. haemulonii, or Saccharomyces when phenotypical identification methods are used. Manufacturers are now working to solve this problem of routine identification, but molecular methods or MALDI-TOF can reliably identify C. auris. We invite you to submit your latest results on C. auris to this Special Issue of the Journal of Fungi.

Sincerely,

Dr. Jacques F. Meis
Dr. Anuradha Chowdhary
Guest Editors

Manuscript Submission Information

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Keywords

  • Candida
  • Candida auris
  • drug resistant fungi
  • infection control
  • emerging fungal diseases

Published Papers (4 papers)

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Research

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Open AccessArticle
Hospital Laboratory Survey for Identification of Candida auris in Belgium
J. Fungi 2019, 5(3), 84; https://doi.org/10.3390/jof5030084 - 05 Sep 2019
Abstract
Candida auris is a difficult-to-identify, emerging yeast and a cause of sustained nosocomial outbreaks. Presently, not much data exist on laboratory preparedness in Europe. To assess the ability of laboratories in Belgium and Luxembourg to detect this species, a blinded C. auris strain [...] Read more.
Candida auris is a difficult-to-identify, emerging yeast and a cause of sustained nosocomial outbreaks. Presently, not much data exist on laboratory preparedness in Europe. To assess the ability of laboratories in Belgium and Luxembourg to detect this species, a blinded C. auris strain was included in the regular proficiency testing rounds organized by the Belgian public health institute, Sciensano. Laboratories were asked to identify and report the isolate as they would in routine clinical practice, as if grown from a blood culture. Of 142 respondents, 82 (57.7%) obtained a correct identification of C. auris. Of 142 respondents, 27 (19.0%) identified the strain as Candida haemulonii. The remaining labs that did not obtain a correct identification (33/142, 23.2%), reported other yeast species (4/33) or failed to obtain a species identification (29/33). To assess awareness about the infection-control implications of the identification, participants were requested to indicate whether referral of this isolate to a reference laboratory was desirable in a clinical context. Over one-third of all respondents (54/142, 38.0%) stated that they would not send the isolate to a reference laboratory, neither for epidemiological reasons nor for identification confirmation or antifungal susceptibility testing. This comprised 41.5% of the laboratories that submitted an identification of C. auris (34/82). Awareness among Belgian microbiologists, therefore, remains inadequate more than two years after C. auris’ emergence in European clinics. Our data confirm high rates of misidentifications with commonly used identification methods. Programs for raising awareness in European hospitals may be warranted. Full article
(This article belongs to the Special Issue Candida auris)
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Open AccessArticle
Does Online Search Behavior Coincide with Candida auris Cases? An Exploratory Study
J. Fungi 2019, 5(2), 44; https://doi.org/10.3390/jof5020044 - 04 Jun 2019
Abstract
Candida auris is an emerging multidrug resistant infectious yeast which is challenging to eradicate and despite available laboratory methods is still difficult to identify especially in less developed countries. To limit the rapid spread of C. auris, quick and accurate detection is [...] Read more.
Candida auris is an emerging multidrug resistant infectious yeast which is challenging to eradicate and despite available laboratory methods is still difficult to identify especially in less developed countries. To limit the rapid spread of C. auris, quick and accurate detection is essential. From the perspective of disease surveillance, additional methods of tracking this yeast are needed. In order to increase global preparedness, we explored the use of online search behavior to monitor the recent global spread of C. auris. We used Google Trends to assess online search behavior on C. auris from January 2016 until August 2018. Weekly Google Trends results were counted as hits and compared to confirmed C. auris cases obtained via publications and a global expert network of key opinion leaders. A total of 44 countries generated a hit, of which 30% (13/44) were confirmed known cases, 34% (15/44) were missed known cases, 34% (15/44) were hits for unknown cases, and 2% (1/44) were confirmed unknown cases. Conclusions: Google Trends searches is rapidly able to provide information on countries with an increased search interest in C. auris. However, Google Trends search results do not generally coincide with C. auris cases or clusters. This study did show that using Google Trends provides both insight into the known and highlights the unknown, providing potential for surveillance and tracking and hence aid in taking timely precautionary measures. Full article
(This article belongs to the Special Issue Candida auris)

Review

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Open AccessReview
Molecular Diagnostics in the Times of Surveillance for Candida auris
J. Fungi 2019, 5(3), 77; https://doi.org/10.3390/jof5030077 - 20 Aug 2019
Abstract
Recently, global health professionals have been significantly challenged by the emergence of Candida auris and its propensity to colonize human skin, persist in the healthcare environment, and cause healthcare-associated outbreaks. Additionally, C. auris isolates are often characterized by elevated minimal inhibitory concentration (MIC) [...] Read more.
Recently, global health professionals have been significantly challenged by the emergence of Candida auris and its propensity to colonize human skin, persist in the healthcare environment, and cause healthcare-associated outbreaks. Additionally, C. auris isolates are often characterized by elevated minimal inhibitory concentration (MIC) values for antifungal drugs. Thus, rapid detection and accurate identification of C. auris together with an assessment of potential antifungal drug resistance has become essential for effective patient management, and infection prevention and control in healthcare facilities. Surprisingly, almost all of the commonly available diagnostic tools rely on recovery (growth) of yeast colonies from collected samples, which delays the diagnostic result by several days or longer. To circumvent these issues, molecular-based DNA amplification assays have been developed to identify C. auris DNA directly from patient samples. Moreover, allele discriminating detection probes can be used to rapidly assess validated mechanisms of echinocandin and azole resistance. Full article
(This article belongs to the Special Issue Candida auris)

Other

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Open AccessPerspective
On the Origins of a Species: What Might Explain the Rise of Candida auris?
J. Fungi 2019, 5(3), 58; https://doi.org/10.3390/jof5030058 - 06 Jul 2019
Cited by 2
Abstract
Candida auris is an emerging multidrug-resistant yeast first described in 2009 that has since caused healthcare-associated outbreaks of severe human infections around the world. In some hospitals, it has become a leading cause of invasive candidiasis. C. auris is markedly different from most [...] Read more.
Candida auris is an emerging multidrug-resistant yeast first described in 2009 that has since caused healthcare-associated outbreaks of severe human infections around the world. In some hospitals, it has become a leading cause of invasive candidiasis. C. auris is markedly different from most other pathogenic Candida species in its genetics, antifungal resistance, and ability to spread between patients. The reasons why this fungus began spreading widely in the last decade remain a mystery. We examine available data on C. auris and related species, including genomic epidemiology, phenotypic characteristics, and sites of detection, to put forth hypotheses on its possible origins. C. auris has not been detected in the natural environment; related species have been detected in in plants, insects, and aquatic environments, as well as from human body sites. It can tolerate hypersaline environments and higher temperatures than most Candida species. We explore hypotheses about the pre-emergence niche of C. auris, whether in the environmental or human microbiome, and speculate on factors that might have led to its spread, including the possible roles of healthcare, antifungal use, and environmental changes, including human activities that might have expanded its presence in the environment or caused increased human contact. Full article
(This article belongs to the Special Issue Candida auris)
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