美国拉什大学医学中心Mary K. Hayden和美国国立卫生研究院Julia A. Segre研究组合作探究了专业护理机构内定植于皮肤耳念珠菌的综合基因组、流行病学特征。该项研究成果发表在2021年6月21日出版的《自然-医学》杂志上。

为了便于监测和提供缓解耳念感染的策略，研究人员确定了皮肤定植的程度并探索了与耳念珠菌定植相关的微生物组。研究人员从 2019 年 1 月至 4 月期间的三个时间点收集了成熟护理机构中 57名个体（每人最多10个身体部位）的拭子标本和临床数据，这些护理机构存在地方性耳念珠菌并进行常规葡萄糖酸氯己定 (CHG) 沐浴。整合微生物基因组和流行病学数据表明隐匿性耳念珠菌通常定植于不作为筛查目标的多个身体部位。高浓度CHG与抑制耳念珠菌的生长有关，但与共生微生物的有害扰动无关。

模拟人类真菌群落动力学提供了观察皮肤真菌群落潜在改变的方法，并可作为获得和检测持续存在耳念珠菌的可能策略。未能检测到广泛、定植于不同部位的耳念珠菌，这可能会降低预防定植个体感染措施的有效性，该研究突出了阻断C. auris 传播的重要性。

据了解，耳念珠菌是常见的真菌病原体，因为它能够引起与医疗保健相关的感染，对抗菌药和消毒剂具有抗药性，并且可在人体皮肤和无生命环境中持久存在。

附：英文原文

Title: Integrated genomic, epidemiologic investigation of Candida auris skin colonization in a skilled nursing facility

Author: Diana M. Proctor, Thelma Dangana, D. Joseph Sexton, Christine Fukuda, Rachel D. Yelin, Mary Stanley, Pamela B. Bell, Sangeetha Baskaran, Clay Deming, Qiong Chen, Sean Conlan, Morgan Park, Rory M. Welsh, Snigdha Vallabhaneni, Tom Chiller, Kaitlin Forsberg, Stephanie R. Black, Massimo Pacilli, Heidi H. Kong, Michael Y. Lin, Michael E. Schoeny, Anastasia P. Litvintseva, Julia A. Segre, Mary K. Hayden

Issue&Volume: 2021-06-21

Abstract: Candida auris is a fungal pathogen of high concern due to its ability to cause healthcare-associated infections and outbreaks, its resistance to antimicrobials and disinfectants and its persistence on human skin and in the inanimate environment. To inform surveillance and future mitigation strategies, we defined the extent of skin colonization and explored the microbiome associated with C. auris colonization. We collected swab specimens and clinical data at three times points between January and April 2019 from 57 residents (up to ten body sites each) of a ventilator-capable skilled nursing facility with endemic C. auris and routine chlorhexidine gluconate (CHG) bathing. Integrating microbial-genomic and epidemiologic data revealed occult C. auris colonization of multiple body sites not targeted commonly for screening. High concentrations of CHG were associated with suppression of C. auris growth but not with deleterious perturbation of commensal microbes. Modeling human mycobiome dynamics provided insight into underlying alterations to the skin fungal community as a possible modifiable risk factor for acquisition and persistence of C. auris. Failure to detect the extensive, disparate niches of C. auris colonization may reduce the effectiveness of infection-prevention measures that target colonized residents, highlighting the importance of universal strategies to reduce C. auris transmission. Longitudinal skin site sampling of residents in a skilled nursing facility sheds light on persistent niches of the emerging fungal pathogen Candida auris.

DOI: 10.1038/s41591-021-01383-w

Source: https://www.nature.com/articles/s41591-021-01383-w