On October 28, the National Institute of Infectious Diseases (INEI) of the National Administration of Laboratories and Health Institutes (ANLIS) “Dr. Carlos G. Malbrán” informed the Epidemiology Directorate of the National Ministry of Health about two isolates of Candida auris from clinical samples of two patients treated at a clinic in the Autonomous City of Buenos Aires. They were identified in a private laboratory in the city by the MALDI-TOF technique and referred to the INEI’s National Reference Laboratory for Clinical Mycology (LNRM) on the same day.
Given this situation, the Epidemiology Operational Management of the Ministry of Health of the Autonomous City of Buenos Aires was informed and a joint meeting was held between the authorities and personnel of the private institution, technical teams from the city and the Ministry of Health of the Nation.
At the same time, the INEI LNRM received the samples from the laboratory that made the first diagnosis and confirmed the identification of Candida auris also by MALDI-TOF. It also carried out antifungal sensitivity studies, the results of which were available on October 31, and advised the staff in charge to be able to offer the appropriate treatment.
One of the isolates comes from a patient hospitalized since October 2 in the intensive care unit of a CABA clinic. He was referred from a clinic outside the country, transferred on a medical flight and currently remains hospitalized. On October 18, a urine culture was performed with isolation of Candida sp., which on October 28 was identified as Candida auris by MALDI-TOF technique in a private laboratory.
The other isolate corresponds to a patient who is treated on an outpatient basis at the same clinic. On October 13, this patient underwent a peritoneal fluid culture where a yeast also identified as Candida auris was isolated on October 28.
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The patients did not share the same environment at the same time during their stay at the clinic and the epidemiological investigation is ongoing.
Based on the information available to date, the teams of the Ministry of Health of the Nation (the Department of Mycology of the National Institute of Infectious Diseases, the Program of Epidemiology and Control Intrahospital Infections “VIHDA” of the INE, the Coordination of Appropriate Use of Antimicrobials, and the Department of Epidemiology) and the Operational Department of Epidemiology of the Ministry of Health of the City of Buenos Aires developed recommendations for the investigation and control of the situation in the institutional sphere of occurrence.
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At the same time, within the framework of the International Health Regulations, the cases were reported through the National Liaison Center to PAHO/WHO and a request for information was sent to the country of origin of the case on the history of pathogens in the clinic where One of the patients was hospitalized.
Candida auris is an emerging pathogen that was isolated and described for the first time in 2009. In 2011, the first case of fungemia caused by this species was described, and in 2012 the first hospital outbreak was reported in the Region of the Americas. Since the first case in 2009, Candida auris has been reported as the causal agent of invasive infections in humans in at least 47 countries. It is transmitted through contact with contaminated environments or with colonized people.
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