Emergence of Candida auris in Russia

Area of Science:

• Medical Mycology
• Infectious Diseases
• Public Health

Background:

• Candida auris is an emerging multidrug-resistant yeast with global health implications.
• Previous outbreaks have been reported in various healthcare settings worldwide.
• Limited data exists on C. auris emergence in Eastern Europe.

Purpose of the Study:

• To report the first series of Candida auris infections in Russia.
• To describe the clinical characteristics, risk factors, and antifungal susceptibilities of these cases.
• To investigate the origin and genetic relatedness of the identified C. auris strains.

Main Methods:

• Retrospective case series analysis of 49 patients diagnosed with C. auris infections.
• Review of clinical data, including risk factors and treatment outcomes.
• Antifungal susceptibility testing.
• Molecular phylogenetic analysis using internal transcribed spacer and D1-D2 regions.
• Analysis of ERG11 gene for K143R substitution.

Main Results:

• Forty-nine cases of C. auris infection were identified between 2016-2017.
• High 30-day all-cause mortality of 42.1% was observed in patients with bloodstream infections lacking appropriate antifungal therapy.
• Phylogenetic analysis indicated the strains were of South Asian origin, suggesting importation.
• The K143R substitution in the ERG11 gene was noted.

Conclusions:

• This study documents the emergence and rapid dissemination of Candida auris in Russia.
• Infections were associated with significant mortality, particularly without adequate antifungal treatment.
• The findings emphasize the urgent need for enhanced international surveillance and control strategies for C. auris.