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. 2021 Mar 17;7(3):220.
doi: 10.3390/jof7030220.

Emergence of Candida auris in Brazil in a COVID-19 Intensive Care Unit

João N de Almeida Jr  1   2   3 , Elaine C Francisco  1 , Ferry Hagen  4   5 , Igor B Brandão  6 , Felicidade M Pereira  7 , Pedro H Presta Dias  8 , Magda M de Miranda Costa  9 , Regiane T de Souza Jordão  10 , Theun de Groot  11 , Arnaldo L Colombo  1
Affiliations

Emergence of Candida auris in Brazil in a COVID-19 Intensive Care Unit

João N de Almeida Jr et al. J Fungi (Basel). .

Abstract

In December 2020, Candida auris emerged in Brazil in the city of Salvador. The first two C. auris colonized patients were in the same COVID-19 intensive care unit. Antifungal susceptibility testing showed low minimal inhibitory concentrations of 1 µg/mL, 2 µg/mL, 0.03 µg/L, and 0.06 µg/mL for amphotericin B, fluconazole, voriconazole, and anidulafungin, respectively. Microsatellite typing revealed that the strains are clonal and belong to the South Asian clade C. auris. The travel restrictions during the COVID-19 pandemic and the absence of travel history among the colonized patients lead to the hypothesis that this species was introduced several months before the recognition of the first case and/or emerged locally in the coastline Salvador area.

Keywords: Brazil; COVID-19; Candida auris; intensive care.

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Conflict of interest statement

A.C. received educational grants from Eurofarma, Pfizer, Gilead Sciences—United Medical (Brazil), TEVA. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
UPGMA phylogenetic tree generated with MEGA X software [8]. There were 20 nucleotide sequences and 299 nucleotide positions in the final dataset. The evolutionary distances were computed using the Maximum Composite Likelihood method and are in the units of number of base substitutions per site.
Figure 2
Figure 2
Short tandem repeat (STR) typing of C. auris isolates from Brazil. UPGMA dendrogram of the Brazilian (L1537/2020 and L1685/2020) and representative strains from South Asian and other four clades are shown. The scale in the upper left corner represents similarity (%).
Figure 3
Figure 3
(A) Erg11p alignment showing the conserved region between the sites 119 and 145 including the azole wildtype Candida albicans ATCC 10231 (1), the Brazilian Candida auris strain L1537 (2), the strain VCPI 1133/P/13-R harboring the mutation K143R (3), and the strain VCPI 1132/P/13-R harboring the mutation Y132F. The azole resistance-related amino acid substitutions K143R and Y132F are highlighted with black squares; (B) Fks1p alignment showing the conserved region between the sites 627 and 662 including the echinocandin wildtype Candida albicans ATCC 10231 (1), the Brazilian Candida auris strain L1537 (2), the strain VCPI 1133/P/13-R harboring the mutation S639F (3), and the echinocandin wildtype strain VCPI 1132/P/13-R.
See this image and copyright information in PMC

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