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Candida auris: Outbreak, surveillance and epidemiological monitoring in Northern Greece

Summary

A dangerous fungus called Candida auris caused an outbreak in hospitals in Northern Greece starting in October 2022. This fungus is particularly concerning because it is resistant to many commonly used antifungal drugs, especially fluconazole. Researchers monitored and tracked the outbreak across multiple hospitals, finding that all cases belonged to the same genetic type (Clade I) and were treatable with certain alternative antifungal medications. The study emphasizes the importance of careful laboratory surveillance and coordinated infection control measures to prevent further spread of this serious infection.

Background

Candida auris is an emerging fungal pathogen associated with multi-drug resistance and widespread hospital outbreaks globally. Different clonal lineages are prevalent in distinct geographical regions. The first case in Northern Greece was reported in Thessaloniki in October 2022, nearly two years after the first isolation in Greece (Athens 2019).

Objective

To monitor the spread of Candida auris in Northern Greece through centralized surveillance procedures, including early isolation, full identification, phylogenetic categorization, and antifungal sensitivity screening to guide infection control measures and antifungal stewardship.

Results

All 90 isolates were resistant to fluconazole (geometric mean 97.76 μg/mL) with sporadic higher MICs for voriconazole but sensitive to amphotericin-B, 5-flucytosine, isavuconazole, itraconazole, posaconazole, and echinocandins. Phylogenetic analysis classified all isolates within South Asian Clade I. Monitoring continued beyond the study period with 50 additional isolates received by end of 2023.

Conclusion

C. auris outbreak in Northern Greece remains under relative control with therapeutic alternatives available, though vigilance is required. All isolates belong to Clade I with consistent sensitivity profiles. Well-organized surveillance and continuous monitoring are essential for preparedness and efficient response to this emerging pathogen.
  • Published in:Medical Mycology,
  • Study Type:Epidemiological surveillance study,
  • Source: 10.1093/mmy/myae062, PMID: 38877671
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