title: Multidrug-Resistant Candida haemulonii and C. auris, Tel Aviv, Israel.
abstract: Candida auris and C. haemulonii are closely related, multidrug-resistant emerging fungal pathogens that are not readily distinguishable with phenotypic assays. We studied C. auris and C. haemulonii clinical isolates from 2 hospitals in central Israel. C. auris was isolated in 5 patients with nosocomial bloodstream infection, and C. haemulonii was found as a colonizer of leg wounds at a peripheral vascular disease clinic. Liberal use of topical miconazole and close contact among patients were implicated in C. haemulonii transmission. C. auris exhibited higher thermotolerance, virulence in a mouse infection model, and ATP-dependent drug efflux activity than C. haemulonii. Comparison of ribosomal DNA sequences found that C. auris strains from Israel were phylogenetically distinct from isolates from East Asia, South Africa and Kuwait, whereas C. haemulonii strains from different countries were closely interrelated. Our findings highlight the pathogenicity of C. auris and underscore the need to limit its spread.
authors.forename: Ronen
authors.initials: R
authors.lastname: Ben-Ami
authors.forename: Judith
authors.initials: J
authors.lastname: Berman
authors.forename: Ana
authors.initials: A
authors.lastname: Novikov
authors.forename: Edna
authors.initials: E
authors.lastname: Bash
authors.forename: Yael
authors.initials: Y
authors.lastname: Shachor-Meyouhas
authors.forename: Shiri
authors.initials: S
authors.lastname: Zakin
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Maor
authors.forename: Jalal
authors.initials: J
authors.lastname: Tarabia
authors.forename: Vered
authors.initials: V
authors.lastname: Schechner
authors.forename: Amos
authors.initials: A
authors.lastname: Adler
authors.forename: Talya
authors.initials: T
authors.lastname: Finn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000494:pharmacology*; D002175:Candida / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D002177:Candidiasis / Q000097:blood / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D026141:Drug Resistance, Multiple, Fungal; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D016533:Mycological Typing Techniques; D012189:Retrospective Studies
chemical_list: D000935:Antifungal Agents
keywords: Candida auris; Candida haemulonii; Israel; antimicrobial resistance; bloodstream infection; fungi; virulence