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Furthermore, C. auris has a propensity for persistence and transmission in health care environments. The reasons for this efficient transmission are not well understood, and therefore we tested whether enhanced resistance to environmental stresses might contribute to the ability of C. auris to spread in health care environments. We compared C. auris to other pathogenic Candida species with respect to their resistance to individual stresses and combinations of stresses. Stress resistance was examined using in vitro assays on laboratory media and also on hospital linen. In general, the 17 C. auris isolates examined displayed similar degrees of resistance to oxidative, nitrosative, cationic and cell wall stresses as clinical isolates of C. albicans, C. glabrata, C. tropicalis, C. parapsilosis, C. krusei, C. guilliermondii, C. lusitaniae and C. kefyr. All of the C. auris isolates examined were more sensitive to low pH (pH 2, but not pH 4) compared to C. albicans, but were more resistant to high pH (pH 13). C. auris was also sensitive to low pH, when tested on contaminated hospital linen. Most C. auris isolates were relatively thermotolerant, displaying significant growth at 47\u00b0C. Furthermore, C. auris was relatively resistant to certain combinations of combinatorial stress (e.g., pH 13 plus 47\u00b0C). Significantly, C. auris was sensitive to the stress combinations imposed by hospital laundering protocol (pH\u00a0&amp;gt;\u00a012 plus heat shock at\u00a0&amp;gt;80\u00b0C), suggesting that current laundering procedures are sufficient to limit the transmission of this fungal pathogen via hospital linen.<\/jats:p>","DOI":"10.1093\/mmy\/myz127","type":"journal-article","created":{"date-parts":[[2019,12,5]],"date-time":"2019-12-05T15:10:36Z","timestamp":1575558636000},"page":"744-755","source":"Crossref","is-referenced-by-count":65,"title":["The environmental stress sensitivities of pathogenic Candida species, including Candida auris, and implications for their spread in the hospital setting"],"prefix":"10.1093","volume":"58","author":[{"given":"Helen","family":"Heaney","sequence":"first","affiliation":[{"name":"Aberdeen Fungal Group, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliette","family":"Laing","sequence":"additional","affiliation":[{"name":"NHS Grampian Central Decontamination Unit, Foresterhill Health Campus, Aberdeen, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Paterson","sequence":"additional","affiliation":[{"name":"NHS Grampian Central Decontamination Unit, Foresterhill Health Campus, Aberdeen, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan W","family":"Walker","sequence":"additional","affiliation":[{"name":"Rowett Institute, University of Aberdeen, Aberdeen, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil A R","family":"Gow","sequence":"additional","affiliation":[{"name":"Aberdeen Fungal Group, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK"},{"name":"MRC Centre for Medical Mycology, University of Exeter, School of Biosciences, Exeter, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth M","family":"Johnson","sequence":"additional","affiliation":[{"name":"Mycology Reference Laboratory, PHE South West Laboratory, Southmead Hospital, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna M","family":"MacCallum","sequence":"additional","affiliation":[{"name":"Aberdeen Fungal Group, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1406-4251","authenticated-orcid":false,"given":"Alistair J P","family":"Brown","sequence":"additional","affiliation":[{"name":"Aberdeen Fungal Group, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK"},{"name":"MRC Centre for Medical Mycology, University of Exeter, School of Biosciences, Exeter, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,1,7]]},"reference":[{"key":"2020080320004815900_bib1","doi-asserted-by":"crossref","first-page":"165rv13","DOI":"10.1126\/scitranslmed.3004404","article-title":"Hidden killers: human fungal infections","volume":"4","author":"Brown","year":"2012","journal-title":"Sci Transl Med"},{"key":"2020080320004815900_bib2","first-page":"371","article-title":"Microbiological profile of organisms causing bloodstream infection in critically ill patients","volume":"4","author":"Orsini","year":"2012","journal-title":"J Clin Med Res"},{"key":"2020080320004815900_bib3","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1097\/CCM.0b013e318206c1ca","article-title":"Candida bloodstream infections in intensive care units: analysis of the extended prevalence of infection in intensive care unit study","volume":"39","author":"Kett","year":"2011","journal-title":"Crit Care 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