Studies describe Candida auris epidemics in COVID-19 patients
Two new studies highlight the threat posed by multidrug-resistant yeast Candida auris to hospitalized COVID-19 patients.
In a case report today in Morbidity and Mortality Weekly Report (MMWR), investigators from the Centers for Disease Control and Prevention and the Florida Department of Health describe an outbreak of C auris in a COVID-19 specialty care unit at an acute care hospital in Florida.
After the hospital alerted Florida health officials about four C auris infections on the unit In July 2020, staff conducted a unit-wide point prevalence survey from August 4 to 18 to identify additional patients colonized by the pathogen. The results showed that of 67 patients admitted to the unit, 35 (52%) were positive, and 6 later had clinical cultures that developed. C auris.
Eight of the colonized patients died within 30 days of screening, but it is not known whether C auris contributed to these deaths.
Investigators concluded that the use of multiple layers of gloves and gowns by healthcare workers, as well as the repeated removal and donning of secondary layers, may have resulted in contamination of the base layers, which in their opinion. tour could have contributed to C auris transmission. They also suggest that gaps in the cleaning and disinfection of shared medical equipment, as well as gaps in adherence to hand hygiene, may have played a role.
January 8 MMWR case report
In the other study, published today in Clinical Microbiology and Infection, Mexican researchers describe the clinical and microbiological characteristics of 12 patients with severe COVID-19 and C auris co-infection in a Mexican hospital in August.
All patients were on mechanical ventilation and had central catheters and urinary catheters inserted peripherally. C auris was isolated from blood in 6 patients, urine in 8 and both sites in two 2. Five of the six patients with blood infections died.
Antifungal susceptibility testing revealed that 8 of 15 isolates (12 from patients and 3 environmental isolates) were multidrug-resistant.
The study authors say that the use of several antibiotics and central venous catheters may have contributed to C auris co-infection in these patients, but they also suggest that factors specifically associated with COVID-19, such as excessive corticosteroid use, which may have an immunosuppressive effect, may also have contributed to the problem.
January 8 Clin Microbiol Infect study
Cats infected with SARS-CoV-2 exhibit long-term immunity and damage
Nine domestic cats inoculated with SARS-CoV-2, the virus that causes COVID-19, showed lung damage and other long-term inflammation in the airways after the virus cleared from their system, reports a Emerging infectious diseases research letter published yesterday. Despite these lingering effects, six re-infected cats showed protection against the disease.
Previous studies have proven that domestic cats can transmit COVID-19 to each other, and researchers also found that the virus replicates efficiently in the upper respiratory organs (nasal passages and trachea), appearing in organ samples and lungs on days 3 and 6 post-infection but absent by day 10 (detectable levels were 10 plaque-forming units per gram of tissue).
No animal exhibited symptoms of respiratory disease throughout the process, but three cats that were euthanized after infection on day 28 exhibited persistent lung damage sharing features with chronic peribronchiolar fibrosis (scarring) and overgrowth. vascular. One cat also had severe pneumonia.
Even with these long-term effects, infection with SARS-CoV-2 seemed to give cats at least some level of protection against reinfection. When the researchers reinfected the remaining six cats about 4 weeks after the initial infection, they found that those who had been euthanized 3 days after the reinfection had no detectable SARS-CoV-2 in their organs or lungs. Cats euthanized 21 days after reinfection had lung lesions comparable to those seen in the first cohort of cats, but the alveolar septa showed less thickening.
“Because SARS-CoV-2 did not cause fatal acute respiratory illness in the cats in our study, the cats are a compelling animal model for studying the long-term effects of non-fatal infections,” the researchers write. “These results suggest that viral infection by natural transmission between cats, as well as by experimental inoculation, induces protective immunity against a second infection with SARS-CoV-2.”
January 7 Emerg Infect Dis research letter
Black populations lack COVID-19 tests, study finds
To have a fair COVID-19 testing strategy in seven counties around St. Louis, 30.4% of tests would need to be reassigned, according to a research letter published today in JAMA Open Network. Researchers defined fair testing as “the balance between the number of tests and the actual burden of disease,” but only 22.9% of COVID-19 tests took place in the 23 zip codes that held 50% of the hospitalizations in the region.
Almost three-quarters of these zip codes (73.9%) had a population of at least 50% Black. Even with the same zip code, black residents consistently had lower inpatient testing rates than their white neighbors.
Researchers collected data from March 14 to August 10 and used a suitable Lorenz curve to measure the number of tests, disease burden, and a color-coded line that varied based on the racial makeup of a zip code. particular. During the study period, 404,904 COVID-19 tests and 4,059 hospitalizations took place in the region, which has a total population of 2,149,222.
âFair testing is essential for a successful COVID-19 response and is essential for early detection of cases, self-isolation and overall prevention of further transmission,â the researchers write. “Lorenz curves provide simple measures that can also be easily followed over time to quantify these disparities.”
January 8 JAMA Netw Open research letter