When novel coronavirus meets candida: exploring the alarming surge of C. auris in Israel

A recent study published in the journal Emerging Infectious Diseases reported epidemics of infectious diseases such as: white ears (C. ear) in Israel.

Study: National Outbreaks of Candida auris Infection Due to Hospitalization Due to COVID-19, Israel, 2021-2022. Image credit: KaterynaKon/Shutterstock.comstudy: Nationwide outbreak of Candida auris infection due to hospitalization due to COVID-19, Israel, 2021-2022. Image credit: KaterynaKon/Shutterstock.com


C. ear is a drug-resistant fungal pathogen that has emerged as a causative agent of nosocomial infections over the past decade.5 in Israel C. ear Infections were reported in 2014-15.

Surveillance activities were then initiated and clinical isolates were sent to national laboratories for further testing. Surveillance indicates a low incidence, but the number of isolates has increased since January 2021.

About research

In this study, researchers investigated infections associated with: C. ear To investigate microbiological and clinical features in Israel and to identify factors causing epidemiological changes. This study included medical facilities that reported at least one clinical isolate. C. ear From January 2014 to May 2022.

The research team obtained data on comorbidities, demographics, previous exposure to antibiotics, ventilator use, and infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or drug-resistant pathogens. . Clinical outcomes included length of hospital stay and intensive care, ventilator use, and in-hospital mortality.

Polymerase chain reaction and sequencing of the internal transcribed spacer (ITS) and D1/D2 regions of ribosomal DNA were performed. Antimycotic susceptibility was tested by microdilution in liquid medium.

The drugs tested were fluconazole, voriconazole, anidulafungin, amphotericin B, and itraconazole. Multi-locus sequence typing was performed to determine genetic relatedness between isolates.

Investigation result

209 overall C. ear Isolates were reported over an 8-year period. From May 2014 to December 2020, 24 cases were detected. C. ear In 2021, the number of infected people will increase sharply, with 120 infected people, a 30-fold increase compared to the previous year. Of his 185 isolates identified since January 2021, most (93%) were from his four hospitals (H1–H4).

128 reports in the first half C. ear Quarantine. 152 patients required repeat cultures C. ear 14 days of fixation. C. ear The incidence in 2021-2022 coincided with the surge in coronavirus disease (COVID-19) cases in 2019.

rapid increase C. ear The cases occurred in January-March 2021, June-November 2021, and January-May 2022 and were synchronized with alpha, delta, and omicron waves, respectively.

many C. ear Cases (88%) had SARS-CoV-2 infection in alpha waves, but decreased to 22% in delta waves and 6.2% in omicron waves.Team entered 22 C. ear Isolates collected prior to December 2020. Most isolates (82%) belonged to clade IV, followed by clades III and II, and of the 43 isolates typed after 2021, 24, 11 and 8 were clade III and IV, respectively. , I belonged to

Antifungal susceptibility rates were 15.6%, 79.6%, 86.4% and 98% for fluconazole, voriconazole, amphotericin B and anidulafungin, respectively. Twenty-one strains were resistant to fluconazole and amphotericin B, and two strains were resistant to anidulafungin, amphotericin B, and fluconazole. All clade III isolates were fluconazole-resistant, compared with 63% of the remaining isolates.

Overall, there were available clinical data for 177 cases. Thirty percent had dementia and half showed impairment. His 78% of patients required a ventilator. More than half of the patients were colonized or infected with other pathogens. Covid-19 was documented before 41 patients became ill C. ear Many (73%) of the patients admitted to the same hospital had serious illnesses.

Half of the COVID-19 patients received remdesivir, and nearly all received corticosteroids. There was no difference between ventilator use and COVID-19 status. However, COVID-19 patients had lower baseline dementia rates, fewer comorbidities, and better functional status.

A total of 70 in-hospital deaths occurred.The researchers further evaluated C. ear Epidemic trends in three hospitals (H1-H3).

Fungal infections were first detected in ventilated COVID-19 patients in the second half of the year, followed by ventilated non-COVID-19 patients. H2 had a similar pattern, but to a lesser extent. In H3, fungal infections, regardless of novel coronavirus disease (COVID-19), were primarily detected in ventilated patients.


The study reported an ongoing problem C. ear Infection and colonization in hospitals in Israel.30-fold increase in annual incidence C. ear In 2021, an infection was observed.

Clade I and Clade III were not circulating in Israel before 2021, suggesting an importation event.Novel coronavirus disease (COVID-19) and ventilators identified as causes of ongoing healthcare-associated infections C. ear Spread.

Surveillance efforts and infection control measures should continue, with a focus on critically ill patients requiring mechanical ventilation.

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