In an MMWR update today, the Centers for Disease Control and Prevention (CDC) now reports 77 cases of emerging, and frequently multidrug-resistant yeast, Candida auris through May 12, 2017 in seven states.
The breakdown by state is as follows: New York (53 cases), New Jersey (16), Illinois (four), Indiana (one), Maryland (one), Massachusetts (one), and Oklahoma (one).
Nearly six out of 10 C. auris cases were isolated from blood and susceptibility testing performed by the CDC shows 86 percent of the 35 isolates tested were resistant to fluconazole (minimum inhibitory concentration [MIC] >32), 15 (43%) were resistant to amphotericin B (MIC ≥2), and one (3%) was resistant to echinocandins (MIC >4).
Nearly all patients had multiple underlying medical conditions and extensive health care facility exposure. Epidemiologic links have been found between most cases.
The MMWR report notes:
All C. auris isolates were forwarded to CDC for whole-genome sequencing and comparison with previously sequenced international isolates, which clustered into four distinct clades. Isolates from within each state were highly related. New York isolates, with the exception of one clinical and one screening case, were highly related to one another and grouped in the same clade as isolates from South Asia. Isolates in New Jersey also were similar to those from South Asia but were distinct from those in New York. Illinois isolates were nearly identical to one another and grouped with isolates from South America. These data suggest multiple introductions of C. auris into the United States followed by local transmission.
Lastly, the CDC says the investigation provides epidemiologic and laboratory data suggesting that this fungus can spread within health care facilities and that interventions are needed to prevent transmission during this early stage of C. auris emergence.
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