Candida auris outbreak involving liver transplant recipients in a surgical intensive care unit. Issue 12 (5th July 2020)

• Record Type: Journal Article
• Authors: Theodoropoulos, Nicole M.; Bolstorff, Barbara; Bozorgzadeh, Adel; Brandeburg, Christina; Cumming, Melissa; Daly, Jennifer S.; Ellison, Richard T.; Forsberg, Kaitlin; Gade, Lalitha; Gibson, Laura; Greenough, Thomas; Litvintseva, Anastasia P.; Mack, Deborah A.; Madoff, Lawrence; Martins, Paulo N.; McHale, Eileen; Melvin, Zita; Movahedi, Babak; Stiles, Tracy; Vallabhaneni, Snigdha; Levitz, Stuart M.
• Is Part Of: American journal of transplantation. Volume 20:Issue 12(2020)
• Page Start: 3673
• Page End: 3679
• Publication Date: 2020-07-05
• Subjects: clinical research/practice -- infection and infectious agents -- infection and infectious agents – fungal -- infectious disease; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.16144
• Languages: English
• ISSNs: 1600-6135

Abstract

Abstract : Candida auris is a yeast that is difficult to eradicate and has caused outbreaks in health care facilities. We report a cluster of 5 patients in 1 intensive care unit who were colonized or infected in 2017. The initial 2 patients were recipients of liver transplants who had cultures that grew C auris within 3 days of each other in June 2017 (days 43 and 30 posttransplant). Subsequent screening cultures identified 2 additional patients with C auris colonization. Respiratory and urine cultures from a fifth patient yielded C auris . All isolates were fluconazole resistant but susceptible to echinocandins. Whole genome sequencing showed the strains were clonal, suggesting in‐hospital transmission, and related but distinct from New York/New Jersey strains, consistent with a separate introduction. However, no source or contact was found. Two of the 5 patients died. C auris infection likely contributed to 1 patient death by infecting a vascular aneurysm at the graft anastomosis. Strict infection control precautions were initiated to control the outbreak. Our experience reveals that although severe disease from C auris can occur in transplant recipients, outbreaks can be controlled using recommended infection control practices. We have had no further patients infected with C auris to date. Abstract : This case series details an outbreak of Candida auris in a surgical intensive care unit that involved organ transplant recipients, including one attributable death, that resolved when infection control methods were implemented.