Integrated genomic, epidemiologic investigation of Candida auris skin colonization in a skilled nursing facility.
Journal
Nature medicine
ISSN: 1546-170X
Titre abrégé: Nat Med
Pays: United States
ID NLM: 9502015
Informations de publication
Date de publication:
08 2021
08 2021
Historique:
received:
29
10
2020
accepted:
05
05
2021
pubmed:
23
6
2021
medline:
18
9
2021
entrez:
22
6
2021
Statut:
ppublish
Résumé
Candida auris is a fungal pathogen of high concern due to its ability to cause healthcare-associated infections and outbreaks, its resistance to antimicrobials and disinfectants and its persistence on human skin and in the inanimate environment. To inform surveillance and future mitigation strategies, we defined the extent of skin colonization and explored the microbiome associated with C. auris colonization. We collected swab specimens and clinical data at three times points between January and April 2019 from 57 residents (up to ten body sites each) of a ventilator-capable skilled nursing facility with endemic C. auris and routine chlorhexidine gluconate (CHG) bathing. Integrating microbial-genomic and epidemiologic data revealed occult C. auris colonization of multiple body sites not targeted commonly for screening. High concentrations of CHG were associated with suppression of C. auris growth but not with deleterious perturbation of commensal microbes. Modeling human mycobiome dynamics provided insight into underlying alterations to the skin fungal community as a possible modifiable risk factor for acquisition and persistence of C. auris. Failure to detect the extensive, disparate niches of C. auris colonization may reduce the effectiveness of infection-prevention measures that target colonized residents, highlighting the importance of universal strategies to reduce C. auris transmission.
Identifiants
pubmed: 34155414
doi: 10.1038/s41591-021-01383-w
pii: 10.1038/s41591-021-01383-w
pmc: PMC9396956
mid: NIHMS1803004
doi:
Types de publication
Journal Article
Research Support, N.I.H., Intramural
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
1401-1409Subventions
Organisme : NCEZID CDC HHS
ID : U54 CK000481
Pays : United States
Organisme : NCEZID CDC HHS
ID : U54 CK000607
Pays : United States
Organisme : CDC HHS
Pays : United States
Investigateurs
Jim Mullikin
(J)
Jim Thomas
(J)
Alice Young
(A)
Gerry Bouffard
(G)
Betty Barnabas
(B)
Shelise Brooks
(S)
Joel Han
(J)
Shi-Ling Ho
(SL)
Juyun Kim
(J)
Richelle Legaspi
(R)
Quino Maduro
(Q)
Holly Marfani
(H)
Casandra Montemayor
(C)
Nancy Riebow
(N)
Karen Schandler
(K)
Brian Schmidt
(B)
Christina Sison
(C)
Mal Stantripop
(M)
Sean Black
(S)
Mila Dekhtyar
(M)
Cathy Masiello
(C)
Jenny McDowell
(J)
Pam Thomas
(P)
Meg Vemulapalli
(M)
Informations de copyright
© 2021. This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.
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