OBJECTIVE Candida auris has recently emerged as a global cause of multidrug resistant fungal outbreaks. An outbreak occurred at a tertiary care center in London in 2016. Transmission characteristics, interventions, patient outcomes and cost of resources are described. METHODS Outbreak interventions included patient isolation, contact screening, single-use equipment, environmental screening and decontamination, staff education, and enhanced surveillance. Risk factors for infection were recorded. Survival probabilities of patients with C. auris and other Candida bloodstream infections (BSI) were calculated. Antifungal susceptibility and epidemiological typing were performed. Actual and opportunity costs of interventions were determined. RESULTS 34 patients acquired the organism including 8 with BSI. Clinical infection was significantly associated with prolonged hospital stay, haemodialysis and antifungal therapy. Variable susceptibility to amphotericin and the triazoles was seen and isolates clustered with the South Asian strains. No significant difference was detected in the survival probabilities of C. auris BSI compared to other candidemias. Outbreak control cost in excess of £1 million and £58,000/month during the subsequent year. CONCLUSION C. auris outbreaks can be controlled by a concerted infection control strategy but can be expensive. Transmission maybe prolonged due to patient movements and unidentified transmission mechanisms.

中文翻译：

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念珠菌暴发：死亡率，干预措施和维持控制的成本。

目的假丝酵母最近已成为引起多药耐药性真菌暴发的全球原因。2016年在伦敦的三级医疗中心发生了一次暴发。描述了传播特征，干预措施，患者预后和资源成本。方法爆发干预措施包括患者隔离，接触筛查，一次性使用设备，环境筛查和净化，员工教育和加强监督。记录感染的危险因素。计算了金黄色葡萄球菌和其他念珠菌血流感染（BSI）患者的生存概率。进行了抗真菌药敏和流行病学分型。确定了干预措施的实际成本和机会成本。结果34例患者获得了该病菌，其中8例患有BSI。临床感染与住院时间延长，血液透析和抗真菌治疗显着相关。观察到对两性霉素和三唑类药物的敏感性不同，分离株与南亚菌株聚集在一起。与其他念珠菌病相比，C。auris BSI的存活率没有显着差异。在接下来的一年中，爆发控制成本超过100万英镑，每月超过58,000英镑。结论可以通过协调一致的感染控制策略来控制金黄色葡萄球菌的暴发，但代价可能很高。由于患者的运动和未知的传播机制，传播可能会延长。与其他念珠菌病相比，C。auris BSI的存活率没有显着差异。在接下来的一年中，爆发控制成本超过100万英镑，每月超过58,000英镑。结论可以通过协调一致的感染控制策略来控制金黄色葡萄球菌的暴发，但代价可能很高。由于患者的运动和未知的传播机制，传播可能会延长。与其他念珠菌病相比，C。auris BSI的存活率没有显着差异。在接下来的一年中，爆发控制成本超过100万英镑，每月超过58,000英镑。结论可以通过协调一致的感染控制策略来控制金黄色葡萄球菌的暴发，但代价可能很高。由于患者的运动和未知的传播机制，传播可能会延长。