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According to published data, commercially available biochemical-based tests, including API AUX 20C and VITEK-2 YST, used in many front line diagnostic laboratories can misidentify C. auris as Candida haemulonii, Saccharomyces cerevisiae or Rhodotorula glutini.<ref name="cdc2" /> | According to published data, commercially available biochemical-based tests, including API AUX 20C and VITEK-2 YST, used in many front line diagnostic laboratories can misidentify C. auris as Candida haemulonii, Saccharomyces cerevisiae or Rhodotorula glutini.<ref name="cdc2" /> | ||
Therefore, it is important that any Candida spp. isolates associated with invasive infections and isolates from superficial sites in patients from high intensity settings and those transferred from an affected hospital (UK or abroad) should be analysed to species level. As knowledge on the epidemiology and prevalence in the UK is as yet limited, PHE is currently not in a position to make specific recommendations with regards to screening policy. However, C. auris screening could be considered for patients at risk for Candida disease (ESCMID guidance developing group define such patients as “[…] mainly ICU patients, paediatric, HIV/AIDS and patients with malignancies including haematopoietic stem cell transplantation.”)<ref name="pmidRef: HPR 10(21)">{{cite journal| author=Schmoldt A, Benthe HF, Haberland G| title=Digitoxin metabolism by rat liver microsomes. | journal=Biochem Pharmacol | year= 1975 | volume= 24 | issue= 17 | pages= 1639-41 | pmid=Ref: HPR 10(21) | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10 }} </ref> | Therefore, it is important that any Candida spp. isolates associated with invasive infections and isolates from superficial sites in patients from high intensity settings and those transferred from an affected hospital (UK or abroad) should be analysed to species level. As knowledge on the epidemiology and prevalence in the UK is as yet limited, PHE is currently not in a position to make specific recommendations with regards to screening policy. However, C. auris screening could be considered for patients at risk for Candida disease (ESCMID guidance developing group define such patients as “[…] mainly ICU patients, paediatric, HIV/AIDS and patients with malignancies including haematopoietic stem cell transplantation.”)<ref name="pmidRef: HPR 10(21)">{{cite journal| author=Schmoldt A, Benthe HF, Haberland G| title=Digitoxin metabolism by rat liver microsomes. | journal=Biochem Pharmacol | year= 1975 | volume= 24 | issue= 17 | pages= 1639-41 | pmid=Ref: HPR 10(21) | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10 }} </ref> | ||
Since April 2015, an adult critical care unit in England has been managing an outbreak of C. auris, with more than 40 patients either colonised or infected; approximately 20% with candidaemia. The hospital outbreak has been difficult to control, despite enhanced infection control interventions, including regular patient screening, environmental decontamination and ward closure<ref name="pmidRef: HPR 10(21)" /> | |||
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Revision as of 02:52, 12 November 2016
This is the sentence to cite.[1]
Therefore it is important that any Candida spp isolates associated with invasive infections and isolates from superficial sites in patients from high intensity settings and those transferred from an affected hospital (UK or abroad) should be analysed to species level. If Candida haemulonii, Candida famata, Candida sake or Saccharomyces cerevisiae are identified, further work should be undertaken to ensure that they are not C. auris. This would involve either molecular sequencing of the D1/D2 domain or MALDI-TOF Biotyper analysis with C. auris either already present or added to the database.[2]
According to published data, commercially available biochemical-based tests, including API AUX 20C and VITEK-2 YST, used in many front line diagnostic laboratories can misidentify C. auris as Candida haemulonii, Saccharomyces cerevisiae or Rhodotorula glutini.[2]
Therefore, it is important that any Candida spp. isolates associated with invasive infections and isolates from superficial sites in patients from high intensity settings and those transferred from an affected hospital (UK or abroad) should be analysed to species level. As knowledge on the epidemiology and prevalence in the UK is as yet limited, PHE is currently not in a position to make specific recommendations with regards to screening policy. However, C. auris screening could be considered for patients at risk for Candida disease (ESCMID guidance developing group define such patients as “[…] mainly ICU patients, paediatric, HIV/AIDS and patients with malignancies including haematopoietic stem cell transplantation.”)[3]
Since April 2015, an adult critical care unit in England has been managing an outbreak of C. auris, with more than 40 patients either colonised or infected; approximately 20% with candidaemia. The hospital outbreak has been difficult to control, despite enhanced infection control interventions, including regular patient screening, environmental decontamination and ward closure[3]
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Overview of Candida auris
Candida auris is a fungus, recently described as a rare cause of fungal infection with significant resistance to antifungal medications.[4] Candida auris isolates from north and south Indian hospitals, Japan and Korea were all found to be resistant to the antifungal medication fluconazole.[4] Some isolates were also noted to be resistant to flucytosine and voriconazole.[4] The high rate of therapeutic failure noted in cases of Candida auris fungemia poses significant concerns.[4] It's high potential for nosocomial horizontal transmission has been demonstrated.[5][6]An outbreak of fifty cases over a sixteen month period (April 2015-July2016) in a cardiothoracic center in London is the first reported case, and the largest outbreak in Europe.[6] It is recognized as a globally emerging fungal pathogen[6].
Historical Perspective
References
- ↑ Centers for Disease Control and Prevention. https://www.cdc.gov/fungal/diseases/candidiasis/candida-auris-alert.html Accessed on November 11th, 2016.
- ↑ 2.0 2.1 Public Health England.https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/534174/Guidance_Candida__auris.pdf. Accessed on November 11th, 2016.
- ↑ 3.0 3.1 Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID HPR 10(21) Ref: HPR 10(21) Check
|pmid=value (help). - ↑ 4.0 4.1 4.2 4.3 Chowdhary A, Anil Kumar V, Sharma C, Prakash A, Agarwal K, Babu R; et al. (2014). "Multidrug-resistant endemic clonal strain of Candida auris in India". Eur J Clin Microbiol Infect Dis. 33 (6): 919–26. doi:10.1007/s10096-013-2027-1. PMID 24357342.
- ↑ Calvo B, Melo AS, Perozo-Mena A, Hernandez M, Francisco EC, Hagen F; et al. (2016). "First report of Candida auris in America: Clinical and microbiological aspects of 18 episodes of candidemia". J Infect. 73 (4): 369–74. doi:10.1016/j.jinf.2016.07.008. PMID 27452195.
- ↑ 6.0 6.1 6.2 Schelenz S, Hagen F, Rhodes JL, Abdolrasouli A, Chowdhary A, Hall A; et al. (2016). "First hospital outbreak of the globally emerging Candida auris in a European hospital". Antimicrob Resist Infect Control. 5: 35. doi:10.1186/s13756-016-0132-5. PMC 5069812. PMID 27777756.