ABSTRACT
A Candida auris outbreak has been ongoing in Southern Nevada since August 2021. In this manuscript we describe the sequencing of over 200 C. auris isolates from patients at several facilities. Genetically distinct subgroups of C. auris were detected from Clade I (3 distinct lineages) and III (1 lineage). Open-source bioinformatic tools were developed and implemented to aid in the epidemiological investigation. The work herein compares three methods for C. auris whole genome analysis: Nullarbor, MycoSNP and a new pipeline TheiaEuk. We also describe a novel analysis method focused on elucidating phylogenetic linkages between isolates within an ongoing outbreak. Moreover, this study places the ongoing outbreaks in a global context utilizing existing sequences provided worldwide. Lastly, we describe how the generated results were communicated to the epidemiologists and infection control to generate public health interventions.
Subject(s)
Candidiasis , Disease Outbreaks , Humans , Nevada/epidemiology , Candida auris/genetics , Candidiasis/epidemiology , Phylogeny , Whole Genome Sequencing , Genome, Fungal , Polymorphism, Single Nucleotide , Microbial Sensitivity Tests , Computational BiologyABSTRACT
Candida auris transmission is steadily increasing across the United States. We report culture-based detection of C. auris in wastewater and the epidemiologic link between isolated strains and southern Nevada, USA, hospitals within the sampled sewershed. Our results illustrate the potential of wastewater surveillance for containing C. auris.
Subject(s)
Candida , Candidiasis , Humans , United States/epidemiology , Candidiasis/drug therapy , Candida auris , Wastewater , Nevada/epidemiology , Wastewater-Based Epidemiological Monitoring , Disease Outbreaks , Antifungal Agents/therapeutic useABSTRACT
Health disparity refers to systematic differences in health outcomes between groups and communities based on socioeconomic isolation. In the USA, health disparities among minority groups, especially African Americans, limit their access to quality medical care and other beneficial resources and services. Presently, the novel coronavirus (COVID-19) highlights the extreme healthcare challenges that exist in the African American and other minority communities in the USA. African Americans are dying at a rate nearly four times higher than the national average. With inadequate access to quality healthcare, viable resources, and information, COVID-19 will continue to have a disastrous effect on African American communities. This communication provides a brief overview of the health inequalities resulting in African Americans dying disproportionately during the COVID-19 pandemic.
Subject(s)
Black or African American , COVID-19/ethnology , Health Services Accessibility , Health Status Disparities , Healthcare Disparities , Minority Groups , Quality of Health Care , Access to Information , COVID-19/mortality , COVID-19/therapy , COVID-19/virology , Coronavirus , Ethnicity , Humans , Pandemics , Racial Groups , SARS-CoV-2 , Socioeconomic Factors , United States/epidemiologyABSTRACT
We describe transmission of Klebsiella pneumoniae carbapenemase-producing Escherichia coli sequence type (ST) 1193 in a group home. E. coli ST1193 is an emerging multidrug-resistant clone not previously shown to carry carbapenemases in the United States. Our investigation illustrates the potential of residential group homes to amplify rare combinations of pathogens and resistance mechanisms.
