{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T11:17:56Z","timestamp":1786792676308,"version":"build-2736575974"},"reference-count":36,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,6,7]],"date-time":"2021-06-07T00:00:00Z","timestamp":1623024000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","award":["2017\/02203\u20107"],"award-info":[{"award-number":["2017\/02203\u20107"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To describe the first outbreak of <jats:italic>Candida<\/jats:italic> <jats:italic>auris<\/jats:italic> in Brazil, including epidemiological, clinical and microbiological data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>After the first <jats:italic>Candida<\/jats:italic> <jats:italic>auris<\/jats:italic>\u2010colonised patient was diagnosed in a COVID\u201019 ICU at a hospital in Salvador, Brazil, a multidisciplinary team conducted a local <jats:italic>C<\/jats:italic>. <jats:italic>auris<\/jats:italic> prevalence investigation. Screening cultures for <jats:italic>C<\/jats:italic>. <jats:italic>auris<\/jats:italic> were collected from patients, healthcare workers and inanimate surfaces. Risk factors for <jats:italic>C<\/jats:italic>. <jats:italic>auris<\/jats:italic> colonisation were evaluated, and the fungemia episodes that occurred after the investigation were also analysed and described. Antifungal susceptibility of the <jats:italic>C<\/jats:italic>. <jats:italic>auris<\/jats:italic> isolates was determined, and they were genotyped with microsatellite analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among body swabs collected from 47 patients, eight (<jats:italic>n<\/jats:italic>\u00a0=\u00a08\/47, 17%) samples from the axillae were positive for <jats:italic>C<\/jats:italic>. <jats:italic>auris<\/jats:italic>. Among samples collected from inanimate surfaces, digital thermometers had the highest rate of positive cultures (<jats:italic>n<\/jats:italic>\u00a0=\u00a08\/47, 17%). Antifungal susceptibility testing showed MICs of 0.5 to 1\u00a0mg\/L for AMB, 0.03 to 0.06\u00a0mg\/L for voriconazole, 2 to 4\u00a0mg\/L for fluconazole and 0.03 to 0.06\u00a0mg\/L for anidulafungin. Microsatellite analysis revealed that all <jats:italic>C<\/jats:italic>. <jats:italic>auris<\/jats:italic> isolates belong to the South Asian clade (Clade I) and had different genotypes. In multivariate analysis, having a colonised digital thermometer was the only independent risk factor associated with <jats:italic>C<\/jats:italic>. <jats:italic>auris<\/jats:italic> colonisation. Three episodes of <jats:italic>C<\/jats:italic>. <jats:italic>auris<\/jats:italic> fungemia occurred after the investigation, with 30\u2010day attributable mortality of 33.3%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Emergence of <jats:italic>C<\/jats:italic>. <jats:italic>auris<\/jats:italic> in Salvador, Brazil, may be related to local <jats:italic>C<\/jats:italic>. <jats:italic>auris<\/jats:italic> clade I closely related genotypes. Contaminated axillary monitoring thermometers may facilitate the dissemination of <jats:italic>C<\/jats:italic>. <jats:italic>auris<\/jats:italic> reinforcing the concept that these reusable devices should be carefully cleaned with an effective disinfectant or replaced by other temperature monitoring methods.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13320","type":"journal-article","created":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T15:56:04Z","timestamp":1621439764000},"page":"1062-1072","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":69,"title":["Axillary Digital Thermometers uplifted a multidrug\u2010susceptible <i>Candida<\/i><i>auris<\/i> outbreak among COVID\u201019 patients in Brazil"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3766-026X","authenticated-orcid":false,"suffix":"Jr","given":"Jo\u00e3o","family":"Nobrega de Almeida","sequence":"first","affiliation":[{"name":"Disciplina de Infectologia, Escola Paulista de Medicina Universidade Federal de S\u00e3o Paulo S\u00e3o Paulo Brazil"},{"name":"Central Laboratory Division Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor B.","family":"Brand\u00e3o","sequence":"additional","affiliation":[{"name":"Comiss\u00e3o de Controle de Infec\u00e7\u00e3o Hospitalar Hospital de Bahia Salvador Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5530-1332","authenticated-orcid":false,"given":"Elaine C.","family":"Francisco","sequence":"additional","affiliation":[{"name":"Disciplina de Infectologia, Escola Paulista de Medicina Universidade Federal de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvio Luis R.","family":"de Almeida","sequence":"additional","affiliation":[{"name":"EpiSUS Secretaria de Vigil\u00e2ncia em Sa\u00fade Minist\u00e9rio da Sa\u00fade Bras\u00edlia Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patr\u00edcia","family":"de Oliveira Dias","sequence":"additional","affiliation":[{"name":"EpiSUS Secretaria de Vigil\u00e2ncia em Sa\u00fade Minist\u00e9rio da Sa\u00fade Bras\u00edlia Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicidade M.","family":"Pereira","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio Central de Sa\u00fade P\u00fablica Professor Gon\u00e7alo Muniz Salvador Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F\u00e1bio","family":"Santos Ferreira","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio Central de Sa\u00fade P\u00fablica Professor Gon\u00e7alo Muniz Salvador Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thaisse Souza","family":"de Andrade","sequence":"additional","affiliation":[{"name":"Superintend\u00eancia de Vigil\u00e2ncia e Prote\u00e7\u00e3o da Sa\u00fade Secretaria de Sa\u00fade do Estado da Bahia Salvador Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magda M.","family":"de Miranda Costa","sequence":"additional","affiliation":[{"name":"Brazilian Health Regulatory Agency Minist\u00e9rio da Sa\u00fade Bras\u00edlia Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regiane T.","family":"de Souza Jord\u00e3o","sequence":"additional","affiliation":[{"name":"CGLAB Minist\u00e9rio da Sa\u00fade Bras\u00edlia Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3253-6080","authenticated-orcid":false,"given":"Jacques F.","family":"Meis","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infectious Diseases ECMM Center of Excellence for Medical Mycology Nijmegen 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