Increasing Number of Cases Due to Candida auris in North Italy, July 2019–December 2022

Author:

Sticchi Camilla1,Raso Roberto2,Ferrara Lorenza2,Vecchi Elena3,Ferrero Loredana4,Filippi Daniela4,Finotto Giuseppe4,Frassinelli Elena4,Silvestre Carlo4,Zozzoli Susanna4,Ambretti Simone56,Diegoli Giuseppe3,Gagliotti Carlo7,Moro Maria Luisa7,Ricchizzi Enrico7,Tumietto Fabio8ORCID,Russo Francesca9,Tonon Michele9ORCID,Maraglino Francesco10,Rezza Giovanni10,Sabbatucci Michela1011ORCID

Affiliation:

1. A.Li.Sa. Azienda Ligure Sanitaria, Ligurian Health Authority, 16121 Genova, Italy

2. Regional Epidemiology Reference Service for the Surveillance, Prevention and Control of Infectious Diseases—Local Health Unit of Alessandria, 15121 Alessandria, Italy

3. Collective Prevention and Public Health Section—Directorate General for Personal Care, Health and Welfare—Emilia Romagna Region, 40100 Bologna, Italy

4. S.C. Health Directorate—P.O. Molinette—A.O.U. Città della Salute e della Scienza, 10126 Turin, Italy

5. Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria Bologna, 40138 Bologna, Italy

6. Section of Microbiology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40126 Bologna, Italy

7. Regional Health and Social Agency—Emilia Romagna Region, 40127 Bologna, Italy

8. UO Antimicrobial Stewardship—AUSL Bologna, 40124 Bologna, Italy

9. Veneto Region, Directorate for Prevention, Veterinary Food Safety, 30123 Venice, Italy

10. Ministry of Health, Directorate General Health Prevention, Communicable Diseases and International Prophylaxis, 00144 Rome, Italy

11. Department Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy

Abstract

Candida auris is an emerging fungus that represents a serious health threat globally. In Italy, the first case was detected in July 2019. Then, one case was reported to the Ministry of Health (MoH) on January 2020. Nine months later, a huge number of cases were reported in northern Italy. Overall, 361 cases were detected in 17 healthcare facilities between July 2019 and December 2022 in the Liguria, Piedmont, Emilia-Romagna, and Veneto regions, including 146 (40.4%) deaths. The majority of cases (91.8%) were considered as colonised. Only one had a history of travel abroad. Microbiological data on seven isolates showed that all but one strain (85.7%) were resistant to fluconazole. All the environmental samples tested negative. Weekly screening of contacts was performed by the healthcare facilities. Infection prevention and control (IPC) measures were applied locally. The MoH nominated a National Reference Laboratory to characterise C. auris isolates and store the strains. In 2021, Italy posted two messages through the Epidemic Intelligence Information System (EPIS) to inform on the cases. On February 2022, a rapid risk assessment indicated a high risk for further spread within Italy, but a low risk of spread to other countries.

Publisher

MDPI AG

Subject

General Medicine

Reference47 articles.

1. Candida auris: An Overview of the Emerging Drug-Resistant Fungal Infection;Sanyaolu;Infect. Chemother.,2022

2. Centers for Disease Control and Prevention (2022, December 01). Tracking Candida Auris, Available online: https://www.cdc.gov/fungal/candida-auris/tracking-c-auris.html.

3. Ahmad, S., and Alfouzan, W. (2021). Candida auris: Epidemiology, Diagnosis, Pathogenesis, Antifungal Susceptibility, and Infection Control Measures to Combat the Spread of Infections in Healthcare Facilities. Microorganisms, 9.

4. Seizing the moment: Now is the time for integrated global surveillance of antimicrobial resistance in wastewater environments;Pruden;Curr. Opin. Microbiol.,2021

5. OECD, ECDC, EFSA, and EMA (2022, December 01). Antimicrobial Resistance in the EU/EEA: A One Health Response. Available online: https://www.ecdc.europa.eu/sites/default/files/documents/antimicrobial-resistance-policy-brief-2022.pdf.

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