Candida aurisoutbreak involving liver transplant recipients in a surgical intensive care unit

Candida aurisis a yeast that is difficult to eradicate and has caused outbreaks in health care facilities. We report a cluster of 5 patients in 1 intensive care unit who were colonized or infected in 2017. The initial 2 patients were recipients of liver transplants who had cultures that grewC auriswithin 3 days of each other in June 2017 (days 43 and 30 posttransplant). Subsequent screening cultures identified 2 additional patients withC auriscolonization. Respiratory and urine cultures from a fifth patient yieldedC auris. All isolates were fluconazole resistant but susceptible to echinocandins. Whole genome sequencing showed the strains were clonal, suggesting in-hospital transmission, and related but distinct from New York/New Jersey strains, consistent with a separate introduction. However, no source or contact was found. Two of the 5 patients died.C aurisinfection likely contributed to 1 patient death by infecting a vascular aneurysm at the graft anastomosis. Strict infection control precautions were initiated to control the outbreak. Our experience reveals that although severe disease fromC auriscan occur in transplant recipients, outbreaks can be controlled using recommended infection control practices. We have had no further patients infected withC auristo date.