Genomic epidemiology describes introduction and outbreaks of antifungal drug-resistant Candida auris
Dana Kappel, Hugh Gifford, Amelie P. Brackin, Alireza Abdolrasouli, David W. Eyre, Katie Jeffery, Silke Schlenz, David Aanensen, Colin Brown, Andrew M. Borman, Elizabeth M. Johnson, Alison Holmes, Darius Armstrong‐James, Matthew C. Fisher, Johanna Rhodes
Abstract
Abstract Candida auris 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 C. auris within the UK. We analysed a representative sample of over 200 isolates from multiple UK hospitals to assess the number and timings of C. auris 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 C. auris are linked and that transmission amongst patients occurs, explaining local hospital outbreaks, and demonstrating a need for improved epidemiological surveillance of C. auris to protect patients and healthcare services.