Microbiology 8 - Clinically Significant Fungi Hospital Inquired Infections - Nosocomial infections - Appears in the first three days in a hospital - The patient doesn't go in with that infection - 5-10% in the US of patients get a nosocomial infection o Affects 2 million a year Candida Auris - Japanese fungus - huge outbreak in Britain o First isolated in Japan from an ear - No found everywhere on the funny - Once it gets into the blood affects the whole body - Has a sweet smell - like a tangerine - About 200 types o 15 causes infections - Candida auris has smaller cells than candida albicans - Have seen outbreaks across the whole globe o Recently in the UK o Luckily no deaths in the UK so far - Has a 66% mortality rate Diagnosis - Most of the people affected are already in the hospitals o Already sick and immune compromised - Sturglling to detect it - Often misdiagnosed - Symptoms are similar to other infections o Quite rare o Don't have mic breakpoints o No extensive plan to detects the organisms o And It spreads quickly o Such as fever and chills - Only a laboratory test can diagnose it Drug resistance - Highly transmissible between patinets and contaminiated environements - They have only been able to find the contaminator a month after the patient has been released o Lurks in the floors and walls for a long time o Spreads on surgical equipment's and blood pressure Not decontaminating their tools - Fluconazole is the drug we give if someone has a fungal infection - When they Mic breakpoint testing, all the isolates form the UK had reduced suspectability to what we were using o Had better susceptibility to other treatments
- First uk in 2013 - infections have gone up - July 2017 - affected 200 patients - Relatively new pathogen - so won't be found in textbooks - A quarter of the detection are in the clinical setting o 27 candidaemias o Outbreaks in 3 large hospital intensive care units Diagnosing within labpryies - Gram staining o Gram positive - purple under the microorganism o Beads that cluster o Candida's make these arrangements o Doesn't distinguish between the candida - Germ tube test o Negative budding yeast - Grow it on cornmeal agar o 42-45oc o Pseudo hyphae arrangement - These tests can take up to a week to detect - In that time, this patient can spread it everywhere - ChromAgar o Incubate in aerobic conditions o 30-37oc for 48 hours o Candida auris - pinky fuzzy colonies o Candida albicans - green - Sabouraud Detoxe Agar o 30oc atmosphere o Aerobic o But not specific to candida auris - Front line test o API kit . 20 reagents dried on a little strip and put staple on there · Let dry over night . Number each one has colours . And add up the numbers · Gives you a unique