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Nationwide Outbreak of Candida auris Infections Driven by COVID-19 Hospitalizations, Israel, 2021-2022

by Yahav, Dafna , Shachor-Meyouhas, Yael , Novikov, Anna , Hershman-Sarafov, Mirit , Burdelova, Ela , Henig, Oryan , Rahav, Galia , Biran, Roni , Lellouche, Jonathan , Ashkenazi-Hoffnung, Liat , Maayan, Shlomo , Zimhony, Oren , Amit, Sharon , Cohen, Regev , Bishara, Jihad , Elbaz, Meital , Mizrahi, Naama , Atamna, Alaa , Schwartz, Orna , Ben Zvi, Haim , Ben-Ami, Ronen , Finn, Talya , Brosh-Nissimov, Tal , Maor, Yasmin

in Anidulafungin / Antifungal agents / Antifungal Agents - pharmacology / Antifungal Agents - therapeutic use / Candida - genetics / Candida auris / Candidiasis / Candidiasis, Invasive - drug therapy / coronavirus disease / COVID-19 / COVID-19 - epidemiology / Disease control / Disease Outbreaks / Drug resistance / Epidemics / Fluconazole / Fungal infections / Health aspects / Hospital care / Hospitalization / Hospitals / Humans / Infection / Infections / Infections Driven by COVID-19 Hospitalizations, Israel, 2021–2022 / Israel / Israel - epidemiology / Laboratories / Microbial Sensitivity Tests / Nationwide Outbreak of / Outbreaks / Patients / Ribosomal DNA / Risk factors / RNA polymerase / SARS-CoV-2 / Severe acute respiratory syndrome coronavirus 2 / Statistics / Surveillance / Ventilation / Ventilators / viruses

2023

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Nationwide Outbreak of Candida auris Infections Driven by COVID-19 Hospitalizations, Israel, 2021-2022

2023

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2023

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Journal Article

Nationwide Outbreak of Candida auris Infections Driven by COVID-19 Hospitalizations, Israel, 2021-2022

Yahav, Dafna,

Shachor-Meyouhas, Yael,

Novikov, Anna,

Hershman-Sarafov, Mirit,

Burdelova, Ela,

Henig, Oryan,

Rahav, Galia,

Biran, Roni,

Lellouche, Jonathan,

Ashkenazi-Hoffnung, Liat,

Maayan, Shlomo,

Zimhony, Oren,

Amit, Sharon,

Cohen, Regev,

Bishara, Jihad,

Elbaz, Meital,

Mizrahi, Naama,

Atamna, Alaa,

Schwartz, Orna,

Ben Zvi, Haim,

Ben-Ami, Ronen,

Finn, Talya,

Brosh-Nissimov, Tal,

Maor, Yasmin

2023

Overview

We report an outbreak of Candida auris across multiple healthcare facilities in Israel. For the period of May 2014-May 2022, a total of 209 patients with C. auris infection or colonization were identified. The C. auris incidence rate increased 30-fold in 2021 (p = 0.00015), corresponding in time with surges of COVID-19-related hospitalization. Multilocus sequence typing revealed hospital-level outbreaks with distinct clones. A clade III clone, imported into Israel in 2016, accounted for 48.8% of typed isolates after January 2021 and was more frequently resistant to fluconazole (100% vs. 63%; p = 0.00017) and voriconazole (74% vs. 5.2%; p<0.0001) than were non-clade III isolates. A total of 23% of patients had COVID-19, and 78% received mechanical ventilation. At the hospital level, outbreaks initially involved mechanically ventilated patients in specialized COVID-19 units and then spread sequentially to ventilated non-COVID-19 patients and nonventilated patients.

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Publisher

U.S. National Center for Infectious Diseases,Centers for Disease Control and Prevention

Subject

Anidulafungin

/ Antifungal agents

/ Antifungal Agents - pharmacology

/ Antifungal Agents - therapeutic use

/ Candida - genetics

/ Candida auris

/ Candidiasis