Objectives
To describe the first outbreak of
Candida
auris
in Brazil, including epidemiological, clinical and microbiological data.
Methods
After the first
Candida
auris
‐colonised patient was diagnosed in a COVID‐19 ICU at a hospital in Salvador, Brazil, a multidisciplinary team conducted a local
C
.
auris
prevalence investigation. Screening cultures for
C
.
auris
were collected from patients, healthcare workers and inanimate surfaces. Risk factors for
C
.
auris
colonisation were evaluated, and the fungemia episodes that occurred after the investigation were also analysed and described. Antifungal susceptibility of the
C
.
auris
isolates was determined, and they were genotyped with microsatellite analysis.
Results
Among body swabs collected from 47 patients, eight (
n
= 8/47, 17%) samples from the axillae were positive for
C
.
auris
. Among samples collected from inanimate surfaces, digital thermometers had the highest rate of positive cultures (
n
= 8/47, 17%). Antifungal susceptibility testing showed MICs of 0.5 to 1 mg/L for AMB, 0.03 to 0.06 mg/L for voriconazole, 2 to 4 mg/L for fluconazole and 0.03 to 0.06 mg/L for anidulafungin. Microsatellite analysis revealed that all
C
.
auris
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
C
.
auris
colonisation. Three episodes of
C
.
auris
fungemia occurred after the investigation, with 30‐day attributable mortality of 33.3%.
Conclusions
Emergence of
C
.
auris
in Salvador, Brazil, may be related to local
C
.
auris
clade I closely related genotypes. Contaminated axillary monitoring thermometers may facilitate the dissemination of
C
.
auris
reinforcing the concept that these reusable devices should be carefully cleaned with an effective disinfectant or replaced by other temperature monitoring methods.