Genomic epidemiology describes introduction and outbreaks of antifungal drug-resistant Candida auris
<i>Candida auris</i> is a globally emerged fungal pathogen causing nosocomial invasive infections. Here, we use cutting-edge genomic approaches to elucidate the temporal and geographic epidemiology of drug-resistant <i>C. auris</i> within the UK. We analysed a representative sample of over 200 isolates from multiple UK hospitals to assess the number and timings of <i>C. auris</i> introductions and infer subsequent patterns of inter- and intra-hospital transmission of azole drug-resistant isolates. We identify at least one introduction from Clade I and two from Clade III into the UK, and observe temporal and geographical evidence for multiple transmission events of antifungal drug resistant isolates between hospitals and identified local within-hospital patient-to-patient transmission events. Our study confirms outbreaks of drug-resistant <i>C. auris</i> are linked and that transmission amongst patients occurs, explaining local hospital outbreaks, and demonstrating a need for improved epidemiological surveillance of <i>C. auris</i> to protect patients and healthcare services.
Authors
- Elizabeth M. Johnson (ORCID: https://orcid.org/0000-0003-3100-6969)
- Darius P. H. Armstrong-James (ORCID: https://orcid.org/0000-0002-1014-7343)
- Katie Jeffery (ORCID: https://orcid.org/0000-0002-6506-2689)
- Hugh Gifford (ORCID: https://orcid.org/0000-0003-2797-852X)
- Johanna L. Rhodes (ORCID: https://orcid.org/0000-0002-1338-7860)
- Alison Holmes (ORCID: https://orcid.org/0000-0001-5554-5743)
- Dana Kappel
- Amelie P. Brackin
- Andrew M. Borman (ORCID: https://orcid.org/0000-0003-0585-5721)
- David W. Eyre (ORCID: https://orcid.org/0000-0001-5095-6367)
- Matthew C. Fisher (ORCID: https://orcid.org/0000-0002-1862-6402)
- Alireza Abdolrasouli (ORCID: https://orcid.org/0000-0002-8934-2343)
- Colin Stewart Brown (ORCID: https://orcid.org/0000-0003-4776-3403)
- David Aanensen
- Silke Schlenz
Institutions
- Radboud University Nijmegen (NL)
- Royal Free London NHS Foundation Trust (GB)
- King's College London (GB)
- University of Exeter (GB)
- Radboud University Medical Center (NL)
- Open Data Institute (GB)
- National Institute for Health and Care Research (GB)
- University of Oxford (GB)
- Oxford University Hospitals NHS Trust (GB)
- King's College Hospital (GB)
- UK Health Security Agency (GB)
- Imperial College London (GB)
- Medical Research Council (GB)
Publication Details
- Journal
- npj Antimicrobials and Resistance
- Published
- 2024-09-30
- DOI
- https://doi.org/10.1038/s44259-024-00043-6
- Citations
- 17
- Primary Topic
- Antifungal resistance and susceptibility
- Type
- article
- Field-Weighted Citation Impact
- 6.61
Funders
- Wellcome
- Wellcome Trust
- Medical Research Council
- Natural Environment Research Council