Volume 27, Number 4—April 2021
Dispatch
Genomic Characterizations of Clade III Lineage of Candida auris, California, USA
Table 1
Characteristics of patients with Candida auris infection, Los Angeles, California, USA, 2019–2020*
Patient | Date of positive PCR | Cycle threshold | C. auris isolate (specimen type) | Approximate age, y | Clinical history | Current signs, symptoms, and diagnosis |
---|---|---|---|---|---|---|
A |
2019 Oct 8 |
22.6 |
UCLA_A1 (inguinal–axillary); UCLA_A2 (tracheal, deemed colonization) |
65 |
Coronary artery disease, stroke, chronic respiratory fracture, tracheostomy and ventilator dependence, gastrostomy tube dependence, urinary incontinence, multiple ulcers, heart failure, atrial fibrillation, and previous carbapenem-resistant Enterobacteriaceae bacteremia. This patient had a prior history of C. auris colonization at the long-term acute-care facility. |
Septic shock caused by methicillin-resistant Staphylococcus aureus bacteremia and multifocal pneumonia. C. auris, Candida albicans, and Candida parapsilosis were isolated from tracheal suction culture. |
B |
2020 July 28 |
39.5 |
Not isolated† |
45 |
Anoxic brain injury caused by MRSA endocarditis and pulseless electrical activity arrest, stroke, and gastrostomy tube dependence. |
Hemoptysis, upper gastrointestinal bleeding, hypotension, and tachycardia. MRSA, Escherichia coli, Providencia stuartii, Proteus mirabilis, and Acinetobacter baumanii grew on blood cultures. Candida glabrata grew on lower respiratory culture. |
C |
2020 Aug 12 |
22.6 |
UCLA_C1 (inguinal–axillary) |
65 |
Hypertension, hyperlipidemia, intracranial hemorrhage and ventriculoperitoneal shunt, tracheostomy, and gastrostomy tube dependence. |
Respiratory failure caused by pulmonary edema. P. mirabilis grew on urine cultures. |
D |
2020 Aug 19 |
39.7 |
UCLA_D1 (inguinal–axillary) |
55 |
Hypertension, hyperlipidemia, type 2 diabetes, aplastic anemia, stroke, pulmonary embolism, pneumothorax, and coronavirus disease–related pneumonia causing respiratory failure, tracheostomy, and gastrostomy tube dependence. |
Elevated liver enzymes and gastrointestinal bleeding complicated by Enterococcus bacteremia and E. coli urinary tract infection. |
E |
2020 Aug 31 |
28.3 |
UCLA_E1 (inguinal–axillary) |
65 |
Hypertension, hyperlipidemia, tracheostomy, and gastrostomy tube dependence. |
Worsening generalized weakness possibly caused by chronic intermittent demyelinating polyneuropathy. |
F | 2020 Sep 3 | 30.6 | UCLA_F1 (pleural fluid, active infection) | 85 | Subarachnoid hemorrhage, tracheostomy, gastrostomy tube dependence, stage IV sacral decubitus ulcer, and chronic kidney disease. This patient had a prior history of C. auris colonization at the long-term acute-care facility. | Bronchopulmonary fistula. C. auris, Pseudomonas aeruginosa, and Enterococcus faecalis grew on pleural fluid cultures. |
*MRSA, methicillin-resistant Staphylococcus aureus. †C. auris was not isolated from the inguinal–axillary surveillance swab of patient B.