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Emergence and Genomic Characterization of Multidrug Resistant Candida auris in Nigeria, West Africa

Candida auris is an emerging multidrug-resistant fungal pathogen that has become a worldwide public health threat due to the limitations of treatment options, difficulty in diagnosis, and its potential for clonal transmission. Four ICU patients from three different healthcare facilities in Southern...

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Autores principales: Oladele, Rita, Uwanibe, Jessica N., Olawoye, Idowu B., Ettu, Abdul-Wahab O., Meis, Jacques F., Happi, Christian T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9410227/
https://www.ncbi.nlm.nih.gov/pubmed/36012776
http://dx.doi.org/10.3390/jof8080787
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author Oladele, Rita
Uwanibe, Jessica N.
Olawoye, Idowu B.
Ettu, Abdul-Wahab O.
Meis, Jacques F.
Happi, Christian T.
author_facet Oladele, Rita
Uwanibe, Jessica N.
Olawoye, Idowu B.
Ettu, Abdul-Wahab O.
Meis, Jacques F.
Happi, Christian T.
author_sort Oladele, Rita
collection PubMed
description Candida auris is an emerging multidrug-resistant fungal pathogen that has become a worldwide public health threat due to the limitations of treatment options, difficulty in diagnosis, and its potential for clonal transmission. Four ICU patients from three different healthcare facilities in Southern Nigeria presented features suggestive of severe sepsis and the blood cultures yielded the growth of Candida spp., which was identified using VITEK 2 as C. auris. Further confirmation was performed using whole genome sequencing (WGS). From the genomic analysis, two had mutations that conferred resistance to the antifungal azole group and other non-synonymous mutations in hotspot genes, such as ERG2, ERG11, and FKS1. From the phylogenetic analysis, cases 2 and 4 had a confirmed mutation (ERG11:Y132F) that conferred drug resistance to azoles clustered with clade 1, whilst cases 1 and 3 clustered with clade 4. Three of the patients died, and the fourth was most likely a case of colonization since he received no antifungals and was discharged home. These first cases of C. auris reported from Nigeria were most likely introduced from different sources. It is of public health importance as it highlights diagnostic gaps in our setting and the need for active disease surveillance in the region.
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spelling pubmed-94102272022-08-26 Emergence and Genomic Characterization of Multidrug Resistant Candida auris in Nigeria, West Africa Oladele, Rita Uwanibe, Jessica N. Olawoye, Idowu B. Ettu, Abdul-Wahab O. Meis, Jacques F. Happi, Christian T. J Fungi (Basel) Article Candida auris is an emerging multidrug-resistant fungal pathogen that has become a worldwide public health threat due to the limitations of treatment options, difficulty in diagnosis, and its potential for clonal transmission. Four ICU patients from three different healthcare facilities in Southern Nigeria presented features suggestive of severe sepsis and the blood cultures yielded the growth of Candida spp., which was identified using VITEK 2 as C. auris. Further confirmation was performed using whole genome sequencing (WGS). From the genomic analysis, two had mutations that conferred resistance to the antifungal azole group and other non-synonymous mutations in hotspot genes, such as ERG2, ERG11, and FKS1. From the phylogenetic analysis, cases 2 and 4 had a confirmed mutation (ERG11:Y132F) that conferred drug resistance to azoles clustered with clade 1, whilst cases 1 and 3 clustered with clade 4. Three of the patients died, and the fourth was most likely a case of colonization since he received no antifungals and was discharged home. These first cases of C. auris reported from Nigeria were most likely introduced from different sources. It is of public health importance as it highlights diagnostic gaps in our setting and the need for active disease surveillance in the region. MDPI 2022-07-27 /pmc/articles/PMC9410227/ /pubmed/36012776 http://dx.doi.org/10.3390/jof8080787 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Oladele, Rita
Uwanibe, Jessica N.
Olawoye, Idowu B.
Ettu, Abdul-Wahab O.
Meis, Jacques F.
Happi, Christian T.
Emergence and Genomic Characterization of Multidrug Resistant Candida auris in Nigeria, West Africa
title Emergence and Genomic Characterization of Multidrug Resistant Candida auris in Nigeria, West Africa
title_full Emergence and Genomic Characterization of Multidrug Resistant Candida auris in Nigeria, West Africa
title_fullStr Emergence and Genomic Characterization of Multidrug Resistant Candida auris in Nigeria, West Africa
title_full_unstemmed Emergence and Genomic Characterization of Multidrug Resistant Candida auris in Nigeria, West Africa
title_short Emergence and Genomic Characterization of Multidrug Resistant Candida auris in Nigeria, West Africa
title_sort emergence and genomic characterization of multidrug resistant candida auris in nigeria, west africa
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9410227/
https://www.ncbi.nlm.nih.gov/pubmed/36012776
http://dx.doi.org/10.3390/jof8080787
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