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Emergence of Clonally-Related South Asian Clade I Clinical Isolates of Candida auris in a Greek COVID-19 Intensive Care Unit

Candida auris has recently emerged as a multidrug-resistant yeast implicated in various healthcare-associated invasive infections and hospital outbreaks. In the current study, we report the first five intensive care unit (ICU) cases affected by C. auris isolates in Greece, during October 2020–Januar...

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Autores principales: Katsiari, Maria, Mavroidi, Angeliki, Kesesidis, Nikolaos, Palla, Eleftheria, Zourla, Konstantina, Ntorlis, Kyriakos, Konstantinidis, Konstantinos, Laskou, Maria, Strigklis, Konstantinos, Sakkalis, Anastasios, Nikolaou, Charikleia, Platsouka, Evangelia D., Karakasiliotis, Ioannis, Vrioni, Georgia, Tsakris, Athanasios
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9964037/
https://www.ncbi.nlm.nih.gov/pubmed/36836357
http://dx.doi.org/10.3390/jof9020243
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author Katsiari, Maria
Mavroidi, Angeliki
Kesesidis, Nikolaos
Palla, Eleftheria
Zourla, Konstantina
Ntorlis, Kyriakos
Konstantinidis, Konstantinos
Laskou, Maria
Strigklis, Konstantinos
Sakkalis, Anastasios
Nikolaou, Charikleia
Platsouka, Evangelia D.
Karakasiliotis, Ioannis
Vrioni, Georgia
Tsakris, Athanasios
author_facet Katsiari, Maria
Mavroidi, Angeliki
Kesesidis, Nikolaos
Palla, Eleftheria
Zourla, Konstantina
Ntorlis, Kyriakos
Konstantinidis, Konstantinos
Laskou, Maria
Strigklis, Konstantinos
Sakkalis, Anastasios
Nikolaou, Charikleia
Platsouka, Evangelia D.
Karakasiliotis, Ioannis
Vrioni, Georgia
Tsakris, Athanasios
author_sort Katsiari, Maria
collection PubMed
description Candida auris has recently emerged as a multidrug-resistant yeast implicated in various healthcare-associated invasive infections and hospital outbreaks. In the current study, we report the first five intensive care unit (ICU) cases affected by C. auris isolates in Greece, during October 2020–January 2022. The ICU of the hospital was converted to a COVID-19 unit on 25 February 2021, during the third wave of COVID-19 in Greece. Identification of the isolates was confirmed by Matrix Assisted Laser Desorption Ionization Time of Flight mass spectroscopy (MALDI-TOF]. Antifungal susceptibility testing was performed by the EUCAST broth microdilution method. Based on the tentative CDC MIC breakpoints, all five C. auris isolates were resistant to fluconazole (≥32 μg/mL), while three of them exhibited resistance to amphotericin B (≥2 μg/mL). The environmental screening also revealed the dissemination of C. auris in the ICU. Molecular characterization of C. auris clinical and environmental isolates was performed by MultiLocus Sequence Typing (MLST) of a set of four genetic loci, namely ITS, D1/D2, RPB1 and RPB2, encoding for the internal transcribed spacer region (ITS) of the ribosomal subunit, the large ribosomal subunit region and the RNA polymerase II largest subunit, respectively. MLST analysis showed that all isolates possessed identical sequences in the four genetic loci and clustered with the South Asian clade I strains. Additionally, PCR amplification and sequencing of the CJJ09_001802 genetic locus, encoding for the “nucleolar protein 58” that contains clade-specific repeats was performed. Sanger sequence analysis of the TCCTTCTTC repeats within CJJ09_001802 locus also assigned the C. auris isolates to the South Asian clade I. Our study confirms that C. auris is an emerging yeast pathogen in our region, especially in the setting of the ongoing COVID-19 worldwide pandemic. Adherence to strict infection control is needed to restrain further spread of the pathogen.
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spelling pubmed-99640372023-02-26 Emergence of Clonally-Related South Asian Clade I Clinical Isolates of Candida auris in a Greek COVID-19 Intensive Care Unit Katsiari, Maria Mavroidi, Angeliki Kesesidis, Nikolaos Palla, Eleftheria Zourla, Konstantina Ntorlis, Kyriakos Konstantinidis, Konstantinos Laskou, Maria Strigklis, Konstantinos Sakkalis, Anastasios Nikolaou, Charikleia Platsouka, Evangelia D. Karakasiliotis, Ioannis Vrioni, Georgia Tsakris, Athanasios J Fungi (Basel) Article Candida auris has recently emerged as a multidrug-resistant yeast implicated in various healthcare-associated invasive infections and hospital outbreaks. In the current study, we report the first five intensive care unit (ICU) cases affected by C. auris isolates in Greece, during October 2020–January 2022. The ICU of the hospital was converted to a COVID-19 unit on 25 February 2021, during the third wave of COVID-19 in Greece. Identification of the isolates was confirmed by Matrix Assisted Laser Desorption Ionization Time of Flight mass spectroscopy (MALDI-TOF]. Antifungal susceptibility testing was performed by the EUCAST broth microdilution method. Based on the tentative CDC MIC breakpoints, all five C. auris isolates were resistant to fluconazole (≥32 μg/mL), while three of them exhibited resistance to amphotericin B (≥2 μg/mL). The environmental screening also revealed the dissemination of C. auris in the ICU. Molecular characterization of C. auris clinical and environmental isolates was performed by MultiLocus Sequence Typing (MLST) of a set of four genetic loci, namely ITS, D1/D2, RPB1 and RPB2, encoding for the internal transcribed spacer region (ITS) of the ribosomal subunit, the large ribosomal subunit region and the RNA polymerase II largest subunit, respectively. MLST analysis showed that all isolates possessed identical sequences in the four genetic loci and clustered with the South Asian clade I strains. Additionally, PCR amplification and sequencing of the CJJ09_001802 genetic locus, encoding for the “nucleolar protein 58” that contains clade-specific repeats was performed. Sanger sequence analysis of the TCCTTCTTC repeats within CJJ09_001802 locus also assigned the C. auris isolates to the South Asian clade I. Our study confirms that C. auris is an emerging yeast pathogen in our region, especially in the setting of the ongoing COVID-19 worldwide pandemic. Adherence to strict infection control is needed to restrain further spread of the pathogen. MDPI 2023-02-11 /pmc/articles/PMC9964037/ /pubmed/36836357 http://dx.doi.org/10.3390/jof9020243 Text en © 2023 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
Katsiari, Maria
Mavroidi, Angeliki
Kesesidis, Nikolaos
Palla, Eleftheria
Zourla, Konstantina
Ntorlis, Kyriakos
Konstantinidis, Konstantinos
Laskou, Maria
Strigklis, Konstantinos
Sakkalis, Anastasios
Nikolaou, Charikleia
Platsouka, Evangelia D.
Karakasiliotis, Ioannis
Vrioni, Georgia
Tsakris, Athanasios
Emergence of Clonally-Related South Asian Clade I Clinical Isolates of Candida auris in a Greek COVID-19 Intensive Care Unit
title Emergence of Clonally-Related South Asian Clade I Clinical Isolates of Candida auris in a Greek COVID-19 Intensive Care Unit
title_full Emergence of Clonally-Related South Asian Clade I Clinical Isolates of Candida auris in a Greek COVID-19 Intensive Care Unit
title_fullStr Emergence of Clonally-Related South Asian Clade I Clinical Isolates of Candida auris in a Greek COVID-19 Intensive Care Unit
title_full_unstemmed Emergence of Clonally-Related South Asian Clade I Clinical Isolates of Candida auris in a Greek COVID-19 Intensive Care Unit
title_short Emergence of Clonally-Related South Asian Clade I Clinical Isolates of Candida auris in a Greek COVID-19 Intensive Care Unit
title_sort emergence of clonally-related south asian clade i clinical isolates of candida auris in a greek covid-19 intensive care unit
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9964037/
https://www.ncbi.nlm.nih.gov/pubmed/36836357
http://dx.doi.org/10.3390/jof9020243
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