Genomic epidemiology and antifungal-resistant characterization of Candida auris, Colombia, 2016-2021.

Since 2016, in Colombia, ongoing transmission of Candida auris has been reported in multiple cities. Here, we provide an updated description of C. auris genomic epidemiology and the dynamics of antifungal resistance in Colombia. We sequenced 99 isolates from C. auris cases with collection dates ranging from June 2016 to January 2021; the resulting sequences coupled with 103 previously generated sequences from C. auris cases were described in a phylogenetic analysis. All C. auris cases were clade IV. Of the 182 isolates with antifungal susceptibility data, 67 (37%) were resistant to fluconazole, and 39 (21%) were resistant to amphotericin B. Isolates predominately clustered by country except for 16 isolates from Bogotá, Colombia, which grouped with isolates from Venezuela. The largest cluster (N = 166 isolates) contained two subgroups. The first subgroup contained 26 isolates, mainly from César; of these, 85% (N = 22) were resistant to fluconazole. The second subgroup consisted of 47 isolates from the north coast; of these, 81% (N = 38) were resistant to amphotericin B. Mutations in the ERG11 and TAC1B genes were identified in fluconazole-resistant isolates. This work describes molecular mechanisms associated with C. auris antifungal resistance in Colombia. Overall, C. auris cases from different geographic locations in Colombia exhibited high genetic relatedness, suggesting continued transmission between cities since 2016. These findings also suggest a lack of or minimal introductions of different clades of C. auris into Colombia. IMPORTANCE: Candida auris is an emerging fungus that presents a serious global health threat and has caused multiple outbreaks in Colombia. This work discusses the likelihood of introductions and local transmission of C. auris and provides an updated description of the molecular mechanisms associated with antifungal resistance in Colombia. Efforts like this provide information about the evolving C. auris burden that could help guide public health strategies to control C. auris spread.

Proporción de leptospirosis y factores relacionados en pacientes con diagnóstico presuntivo de dengue, 2010-2012 / Leptospirosis percentage and related factors in patients having a presumptive diagnosis of dengue, 2010 -2012

Objetivo Identificar la presencia de leptospirosis y las variables sociodemográficas relacionadas, en pacientes con diagnóstico confirmado y descartado de dengue en el periodo 2010-2012, por medio de la técnica de microaglutinación (MAT). Materiales y Métodos Se realizó un estudio descriptivo retrospectivo de 238 sueros: 106 de pacientes fallecidos: 64 dengue negativo y 42 dengue positivo y 132 muestras de pacientes vivos dengue positivo: 29 confirmados por PCR y/o aislamiento viral y 103 con IgM positiva, a todos los sueros se les realizó la técnica de MAT para Leptospira, se revisaron las fichas epidemiológicas y se analizaron los datos. Resultados De los 42 pacientes fallecidos dengue positivo, 3 (7%) se encontraron positivos para Leptospira interrogans serogrupo Australis y Autumnalis; 2 mujeres, de 5 y 17 años y un hombre de 14 años.De los 64 pacientes fallecidos negativos para dengue, 7(11%) se encontraron positivos para L. interrogans de los serogrupos Pomona, Autumnalis, Canicola y Ballum; 5 hombres; edades entre 8 y 58 años; y 2 mujeres edades de 35 y 56 años. De los 103 pacientes vivos con IgM positiva para dengue, 3(2,9%) se encontraron positivos para Leptospira de los serogrupos Icterohaemorrhagiae, Cynopteri, Javanica, Proechimys y Autumnalis; 1 hombre y 2 mujeres. En los 29 pacientes vivos confirmados para dengue, no se encontraron positivos para Leptospira. Conclusiones Se debe sospechar de leptospirosis, no solo como único agente causal del síndrome febril, sino también de la coinfección que podría comprometer al paciente y estar relacionada con la mortalidad.(AU)

Objective Using the microscopic agglutination test (MAT) from 2010-2012 for identify ingleptospirosis-related and sociodemographic variables in patients havinga confirmed diagnosis of dengue and those for whom it had been discarded. Materials and Methods This was aretrospective study of 238 sera samples. 106 patients died, 64 of their samples were negative for dengue and 42 proved positive. 132 samples from live patients proved positive for dengue; 29 were confirmed by PCR and/orvirus isolation and 103 had positive IgM readings. MAT was used for all seraand diagnosing Leptospira, epidemiological records were reviewed and the data was analysed. Results 42 dengue positive patients died; 3 (7%) were positive for Leptospira interrogans sero group Australisautumnalis (two girls aged 5 and 17 years-old anda 14 year-old boy). Of the 64 deceased patients who proved negative for dengue, 7 (11%) were found positive for L.interrogans from sero groups Pomona, Autumnalis, Canicola and Ballum (5 malesaged 8to 58 years-old and 2 womenaged 35 and 56 years-old). Of the 103 living patients who proved positive for dengue IgM, 3 (2.9%) were positive for Leptospira icterohaemorrhagiae from the Cynopteri, Javanica Proechimys and Autumnalissero groups(1 maleand 2 females). None of the 29 living patients confirmedas having dengue were positive for Leptospira. Conclusions Leptospirosis should be suspected not onlyas the solecausative agent of febrile syndromebut also of co-infection which could compromisea patient and be related tomortality.(AU)

[Leptospirosis percentage and related factors in patients having a presumptive diagnosis of dengue, 2010 -2012]. / Proporción de leptospirosis y factores relacionados en pacientes con diagnóstico presuntivo de dengue, 2010-2012.

OBJECTIVE: Using the microscopic agglutination test (MAT) from 2010-2012 for identifying leptospirosis-related and sociodemographic variables in patients having a confirmed diagnosis of dengue and those for whom it had been discarded. MATERIALS AND METHODS: This was a retrospective study of 238 sera samples. 106 patients died, 64 of their samples were negative for dengue and 42 proved positive. 132 samples from live patients proved positive for dengue; 29 were confirmed by PCR and/or virus isolation and 103 had positive IgM readings. MAT was used for all sera and diagnosing Leptospira, epidemiological records were reviewed and the data was analysed. RESULTS: 42 dengue positive patients died; 3 (7%) were positive for Leptospira interrogans sero group Australis autumnalis (two girls aged 5 and 17 years-old and a 14 year-old boy). Of the 64 deceased patients who proved negative for dengue, 7 (11%) were found positive for L.interrogans from sero groups Pomona, Autumnalis, Canicola and Ballum (5 males aged 8 to 58 years-old and 2 women aged 35 and 56 years-old). Of the 103 living patients who proved positive for dengue IgM, 3 (2.9%) were positive for Leptospira icterohaemorrhagiae from the Cynopteri, Javanica Proechimys and Autumnalis sero groups(1 male and 2 females). None of the 29 living patients confirmed as having dengue were positive for Leptospira. CONCLUSIONS: Leptospirosis should be suspected not only as the sole causative agent of febrile syndrome but also of co-infection which could compromise a patient and be related to mortality.