Tracing the Evolutionary History and Global Expansion of Candida auris Using Population Genomic Analyses

mBio - Tập 11 Số 2 - 2020
Nancy A. Chow1, José F. Muñoz2, Lalitha Gade1, Elizabeth L. Berkow1, Li Xiao2, Rory M. Welsh1, Kaitlin Forsberg1, Shawn R. Lockhart1, Rodney D. Adam3, Alexandre Alanio4,5,6, Ana Alastruey‐Izquierdo7, Sahar Althawadi8, Ana Belén Araúz9, Ronen Ben‐Ami10,11, Amrita Bharat12, Belinda Calvo13, Marie Desnos‐Ollivier4, Patricia Escandón14, Dianne Gardam15, Gunturu Revathi3, Christopher H. Heath16,15,17,18, Oliver Kurzai19,20, Ronny Martin19,20, Anastasia P. Litvintseva1, Christina A. Cuomo2
1Mycotic Diseases Branch, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, Georgia, USA
2Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
3Department of Pathology, Aga Khan University Hospital, Nairobi, Kenya
4Institut Pasteur, Molecular Mycology Unit, CNRS UMR2000, National Reference Center for Invasive Mycoses and Antifungals (NRCMA), Paris, France
5Laboratoire de Parasitologie-Mycologie, Hôpital Saint-Louis, Groupe Hospitalier Lariboisière, Saint-Louis, Fernand Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
6Université Paris Diderot, Université de Paris, Paris, France
7Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
8Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
9Hospital Santo Tomás, Panama City, Panama
10Infectious Diseases Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
11Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
12National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
13Department of Infectious Diseases, School of Medicine, Universidad del Zulia, Maracaibo, Venezuela
14Grupo de Microbiología, Instituto Nacional de Salud, Bogotá, Colombia
15Department of Microbiology, PathWest Laboratory Medicine FSH Network, Fiona Stanley Hospital, Murdoch, Australia
16Department of Infectious Diseases, Fiona Stanley Hospital, Murdoch, Australia
17Faculty of Health & Medical Sciences, University of Western Australia, Crawley, Washington, Australia
18Infectious Diseases, Royal Perth Hospital, Perth, Australia
19German National Reference Center for Invasive Fungal Infections NRZMyk, Leibniz Institute for Natural Product Research and Infection Biology–Hans-Knöll-Institute, Jena, Germany
20Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany

Tóm tắt

In less than a decade, C. auris has emerged in health care settings worldwide; this species is capable of colonizing skin and causing outbreaks of invasive candidiasis. In contrast to other Candida species, C. auris is unique in its ability to spread via nosocomial transmission and its high rates of drug resistance. As part of the public health response, whole-genome sequencing has played a major role in characterizing transmission dynamics and detecting new C. auris introductions. Through a global collaboration, we assessed genome evolution of isolates of C. auris from 19 countries. Here, we described estimated timing of the expansion of each C. auris clade and of fluconazole resistance, characterized discrete phylogeographic population structure of each clade, and compared genome data to sensitivity measurements to describe how antifungal resistance mechanisms vary across the population. These efforts are critical for a sustained, robust public health response that effectively utilizes molecular epidemiology.

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