Emergence of Candida (Candidozyma) auris in Minas Gerais, Brazil: Genomic Surveillance to Guide Rapid Public Health Responses.
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Tomé Luiz Marcelo Ribeiro, Camargo Dhian Renato Almeida, Bastos Rafael Wesley, Dos Santos Sara Cândida Ferreira, Guimarães Natália Rocha, Pedroso Sílvia Helena Sousa Pietra, de Souza da Silva Paulo Eduardo, Góes-Neto Aristóteles, de Assis Figueredo Lida Jouca, da Côrte Castro Gabriella, Rodrigues Ana Maria Ribeiro Nunes, Cruzeiro Flavia Ribeiro Soares, Dutra Nádia Aparecida Campos, Moura Josiane Barbosa Piedade, de Carvalho Pereira Glauco, Faria Carmem Dolores, Giovanetti Marta, de Melo Iani Felipe Campos, Alcantara Luiz Carlos Júnior, Adelino Talita Émile Ribeiro
Аннотация
OBJECTIVES: To report the first identification and genomic characterisation of C. auris in the state of Minas Gerais, Southeast Brazil, and to investigate the genetic origin and diversity, resistance-associated mutations, and potential transmission dynamics during a hospital outbreak.
METHODS: Eight C. auris isolates were collected during a hospital outbreak in Belo Horizonte, Minas Gerais, Brazil, including clinical samples from patients and environmental samples from surfaces in the Intensive Care Unit (ICU). Epidemiological investigation, whole-genome sequencing (WGS) and phylogenomic analyses were conducted to determine circulating clade, genetic diversity, outbreak origin and the presence of antifungal resistance mutations.
RESULTS: All isolates were classified as clade IV and exhibited high genomic similarity to strains previously reported in northern Colombia (Caribbean coast). One isolate carried the ERG11 Y132F mutation, associated with fluconazole resistance, but this mutation was absent in another isolate from the same patient collected 1 day earlier, indicating mixed fungal populations. Environmental isolates clustered tightly with clinical strains, supporting surface-mediated transmission in the ICU.
CONCLUSIONS: This study describes the introduction and local spread of clade IV C. auris in Minas Gerais, Brazil. The findings underscore the critical role of genomic surveillance in identifying resistance mechanisms, tracing transmission pathways and guiding public health responses.