{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T11:40:57Z","timestamp":1790422857652,"version":"4.1.0"},"reference-count":35,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,6,16]],"date-time":"2024-06-16T00:00:00Z","timestamp":1718496000000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p><jats:italic>Candida auris<\/jats:italic> is an emerging multidrug\u2010resistant yeast, frequently causing outbreaks in health care facilities. The pathogen persistently colonises human skin and inanimate surfaces such as catheters, aiding to its spread. Moreover, colonisation is a risk factor to develop invasive infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We investigated 61 <jats:italic>C.\u2009auris<\/jats:italic> strains isolated from non\u2010sterile human body sites (<jats:italic>n<\/jats:italic>\u2009=\u200953) and the hospital environment (<jats:italic>n<\/jats:italic>\u2009=\u20098), originating from four different centres in a single Brazilian state.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Antifungal susceptibility testing (AFST) against common antifungals was performed, and resistance\u2010associated genes were evaluated. Genetic relatedness was investigated with short tandem repeat (STR) genotyping and validated with whole\u2010genome sequencing (WGS) single nucleotide polymorphism (SNP) analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Antifungal susceptibility testing demonstrated that all isolates were susceptible to azoles, echinocandins and amphotericin B. No mutations were detected in <jats:italic>ERG11<\/jats:italic> and <jats:italic>FKS1<\/jats:italic> genes. With STR typing, isolates were allocated to clade IV and appeared closely related. This was confirmed by WGS SNP analysis of 6 isolates, which demonstrated a maximal difference of only 41 SNPs between these strains. Furthermore, the Brazilian isolates formed a distinct autochthonous branch within clade IV, excluding recent introductions from outside the country. A molecular clock analysis of clade IV isolates from various countries suggests that early in the previous century there was a unique event causing environmental spread of a <jats:italic>C.\u2009auris<\/jats:italic> ancestor throughout the Latin\u2010American continent, followed by human introduction during the last decades.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We report the emergence of <jats:italic>C.\u2009auris<\/jats:italic> patient colonisation in multiple centres by fluconazole\u2010susceptible clade IV close\u2010related strains in Pernambuco State, Brazil.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13752","type":"journal-article","created":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T03:13:49Z","timestamp":1718594029000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Multicenter <i>Candida auris<\/i> outbreak caused by azole\u2010susceptible clade <scp>IV<\/scp> in Pernambuco, Brazil"],"prefix":"10.1111","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6734-361X","authenticated-orcid":false,"given":"Bram","family":"Spruijtenburg","sequence":"first","affiliation":[{"name":"Radboudumc\u2010CWZ Center of Expertise for Mycology  Nijmegen The Netherlands"},{"name":"Canisius\u2010Wilhelmina Hospital (CWZ)\/Dicoon  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3766-026X","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Nobrega\u00a0de\u00a0Almeida\u00a0J\u00fanior","sequence":"additional","affiliation":[{"name":"Disciplina de Infectologia, Escola Paulista de Medicina Universidade Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"},{"name":"Antimicrobial Resistance Institute of S\u00e3o Paulo\u2010ARIES  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3677-3243","authenticated-orcid":false,"given":"Felipe de Camargo","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Disciplina de Infectologia, Escola Paulista de Medicina Universidade Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"},{"name":"Antimicrobial Resistance Institute of S\u00e3o Paulo\u2010ARIES  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9991-5662","authenticated-orcid":false,"given":"Karoline Kristina","family":"Kemmerich","sequence":"additional","affiliation":[{"name":"Disciplina de Infectologia, Escola Paulista de Medicina Universidade Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"},{"name":"Antimicrobial Resistance Institute of S\u00e3o Paulo\u2010ARIES  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9981-8835","authenticated-orcid":false,"given":"Karla","family":"Baeta","sequence":"additional","affiliation":[{"name":"Ag\u00eancia Pernambucana de Vigil\u00e2ncia Sanit\u00e1ria  Recife Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0226-024X","authenticated-orcid":false,"given":"Eelco F. J.","family":"Meijer","sequence":"additional","affiliation":[{"name":"Radboudumc\u2010CWZ Center of Expertise for Mycology  Nijmegen The Netherlands"},{"name":"Canisius\u2010Wilhelmina Hospital (CWZ)\/Dicoon  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5841-6461","authenticated-orcid":false,"given":"Theun","family":"de Groot","sequence":"additional","affiliation":[{"name":"Radboudumc\u2010CWZ Center of Expertise for Mycology  Nijmegen The Netherlands"},{"name":"Canisius\u2010Wilhelmina Hospital (CWZ)\/Dicoon  Nijmegen The Netherlands"}],"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":"Radboudumc\u2010CWZ Center of Expertise for Mycology  Nijmegen The Netherlands"},{"name":"Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging\u2010Associated Diseases (CECAD) and Excellence Center for Medical Mycology, University of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0793-8491","authenticated-orcid":false,"given":"Arnaldo Lopes","family":"Colombo","sequence":"additional","affiliation":[{"name":"Disciplina de Infectologia, Escola Paulista de Medicina Universidade Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"},{"name":"Antimicrobial Resistance Institute of S\u00e3o Paulo\u2010ARIES  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Brazilian Candida auris collaborative network","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,16]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-micro-032521-015858"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms9040807"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.7326\/M22-3469"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40121-022-00625-9"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-021-01383-w"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciad752"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1101\/2023.08.01.23293435"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1128\/mBio.03364-19"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mib.2019.05.008"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw691"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40560-018-0342-4"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.4067\/S0716-10182019000600767"},{"issue":"4","key":"e_1_2_10_14_1","first-page":"261","article-title":"Un pat\u00f3geno f\u00fangico emergente multirresistente en Argentina","volume":"54","author":"Fernandez NB","year":"2022","journal-title":"Rev Argent Microbiol"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof7030220"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13320"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2023.1033707"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof6030146"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof7090754"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.03355-13"},{"key":"e_1_2_10_21_1","unstructured":"The European Committee on Antimicrobial Susceptibility Testing.Method for the determination of broth dilution minimum inhibitory concentrations of antifungal agents for yeasts. 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