PMID- 34485470
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220426
IS  - 2313-1810 (Electronic)
IS  - 2312-0053 (Print)
IS  - 2312-0053 (Linking)
VI  - 35
IP  - 1
DP  - 2020
TI  - Multilocus sequence typing of azole-resistant Candida auris strains, South 
      Africa.
PG  - 116
LID - 10.4102/sajid.v35i1.116 [doi]
LID - 116
AB  - BACKGROUND: Candida auris is an emerging multidrug-resistant fungal pathogen 
      associated with high mortality. METHODS: We investigated the genetic relatedness 
      of clinical C. auris isolates from patients admitted to either public- or 
      private-sector hospitals, which were submitted to a reference laboratory from 
      2012 to 2015. Patient demographics and clinical details were recorded. We 
      performed antifungal susceptibility testing, sequencing of the hotspot 1 and 2 
      regions of the FKS1 and FKS2 genes for all isolates with an echinocandin minimum 
      inhibitory concentration (MIC) of >/=1 microg/mL and cluster analysis using multilocus 
      sequence typing. RESULTS: Eighty-five isolates were confirmed as C. auris. The 
      median patient age was 59 years [inter-quartile range (IQR): 48-68 years], with 
      male patients accounting for 68% of cases. Specimen types included urine (29%), 
      blood (27%), central venous catheter tips (25%), irrigation fluid (7%), tissue 
      (5%), respiratory tract specimens (4%) and other (3%). Ninety-seven per cent of 
      isolates were resistant to fluconazole, 7% were resistant to both fluconazole and 
      voriconazole, 8% were resistant to both fluconazole and echinocandins (considered 
      multidrug resistant) and all were susceptible to amphotericin B. Of the 15 
      randomly selected fluconazole-resistant isolates, 14 isolates had an 
      isavuconazole MIC </= 1 microg/mL. No FKS mutations were detected. Multilocus sequence 
      typing (MLST) analysis grouped isolates into two clusters: cluster 1 and cluster 
      2 comprising 83 and 2 isolates, respectively. CONCLUSIONS: Azole-resistant C. 
      auris strains circulating in South African hospitals were related by MLST, but 
      the possibility of nosocomial transmission should be explored using a more 
      discriminatory technique, for example, whole genome sequencing.
CI  - (c) 2020. The Authors.
FAU - Magobo, Rindidzani
AU  - Magobo R
AUID- ORCID: 0000-0002-0950-0146
AD  - Centre for Healthcare-associated Infections, Antimicrobial Resistance and 
      Mycoses, Division of the National Health Laboratory Service, National Institute 
      for Communicable Diseases, Johannesburg, South Africa.
AD  - Ampath National Reference Laboratory, Pretoria, South Africa.
FAU - Mhlanga, Mabatho
AU  - Mhlanga M
AUID- ORCID: 0000-0003-0289-6456
AD  - Centre for Healthcare-associated Infections, Antimicrobial Resistance and 
      Mycoses, Division of the National Health Laboratory Service, National Institute 
      for Communicable Diseases, Johannesburg, South Africa.
FAU - Corcoran, Craig
AU  - Corcoran C
AUID- ORCID: 0000-0002-8493-9810
AD  - Ampath National Reference Laboratory, Pretoria, South Africa.
FAU - Govender, Nelesh P
AU  - Govender NP
AUID- ORCID: 0000-0001-7869-9462
AD  - Centre for Healthcare-associated Infections, Antimicrobial Resistance and 
      Mycoses, Division of the National Health Laboratory Service, National Institute 
      for Communicable Diseases, Johannesburg, South Africa.
LA  - eng
PT  - Journal Article
DEP - 20200323
PL  - South Africa
TA  - S Afr J Infect Dis
JT  - Southern African journal of infectious diseases
JID - 101646666
PMC - PMC8378186
OTO - NOTNLM
OT  - Candida auris
OT  - FKS sequencing
OT  - South Africa
OT  - azole resistant
OT  - multilocus sequence typing
COIS- For unrelated activities over the last 36 months, Nelesh P. Govender has received 
      a speaker honorarium from Astellas and a travel grant from MSD (Pty)Ltd. For the 
      remaining authors, none were declared.
EDAT- 2020/03/23 00:00
MHDA- 2020/03/23 00:01
PMCR- 2020/03/23
CRDT- 2021/09/06 06:08
PHST- 2019/05/28 00:00 [received]
PHST- 2020/01/16 00:00 [accepted]
PHST- 2021/09/06 06:08 [entrez]
PHST- 2020/03/23 00:00 [pubmed]
PHST- 2020/03/23 00:01 [medline]
PHST- 2020/03/23 00:00 [pmc-release]
AID - SAJID-35-116 [pii]
AID - 10.4102/sajid.v35i1.116 [doi]
PST - epublish
SO  - S Afr J Infect Dis. 2020 Mar 23;35(1):116. doi: 10.4102/sajid.v35i1.116. 
      eCollection 2020.