Hospital outbreaks predominated by Clade I Candida auris in Beijing, China, and evaluation of screening strategies.
- 1Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
- 2Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. [email protected].
- 3Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. [email protected].
Abstract
Background
Candida auris has emerged as a global public health threat, with an increasing number of outbreak events reported in Beijing, the capital city of China. This study aimed to characterize the epidemic clones currently circulating in the city through population genomic analysis, and to evaluate and optimize targeted screening strategies.Methods
A total of 227 C. auris isolates were analyzed, including 106 C. auris isolates collected from 23 patients admitted to Peking Union Medical College Hospital (PUMCH) during 2021-2025, and an additional 121 Clade I C. auris genomes from 10 cities in China. Phylogenetic analysis and pairwise single nucleotide polymorphisms (SNPs) were used to determine genomic relatedness of isolates. Nosocomial screening of patients and the healthcare environment was conducted using on-site direct and enrichment culture, and a real-time PCR-based assay.Results
In PUMCH, 20 out of 23 (93.40%) patients were colonized by Clade I C. auris isolates. Whole genome sequencing analysis of 173 Clade I C. auris isolates collected in Beijing revealed three major sublineages. Notably, Beijing Sublineages I and II formed phylogenetically independent clusters, whereas Beijing Sublineage III clustered with a major sublineage circulating in East China, indicating inter-regional dissemination. High-resolution pairwise SNP analysis further suggested multiple introductions into the predominant department, the medical intensive care unit at PUMCH, and provided evidence for inter-institutional transmission. Comparative analysis of screening methods demonstrated that enrichment culture increased the C. auris screen-positive rate by 18.52% (10/54) compared with using direct culture alone. Real-time PCR cycle threshold (Ct) values showed a good correlation with semi-quantitative culture results, and samples with Ct values ≤ 30 exhibited high culture positive rates compared with those with Ct values > 30, Additionally, decolonization attempts with chlorhexidine resulted in only a brief increase in Ct values, with the patient's fungal loads returning to baseline within 7 days.Conclusion
Clade I C. auris isolates constituted the predominant lineage spreading in Beijing. Given that evidence of both inter-regional and inter-institutional dissemination has been collected, effective coordination and information sharing between healthcare institutions are critical. Ct value-based stratification of transmission risk may complement the limited sensitivity of culture-based methods, and support practical implementation of infection prevention and control measures.
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BibTeX
@article{liu2026hospital,
title = {{Hospital outbreaks predominated by Clade I Candida auris in Beijing, China, and evaluation of screening strategies.}},
author = {Fei-Yi Liu and Xin-Fei Chen and Qing Wang and Rong-Chen Dai and Han Zhang and Hui-Qing Zhu and Yu-Yan Huang and Yi-Ying Zhao and Ke-Yu Liu and Wei Kang and Jin Li and Ying-Chun Xu and Meng Xiao},
journal = {BMC microbiology},
year = {2026},
month = aug,
doi = {10.1186/s12866-026-05475-w},
url = {https://europepmc.org/article/MED/42972497},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Hospital outbreaks predominated by Clade I Candida auris in Beijing, China, and evaluation of screening strategies.
AU - Fei-Yi Liu
AU - Xin-Fei Chen
AU - Qing Wang
AU - Rong-Chen Dai
AU - Han Zhang
AU - Hui-Qing Zhu
AU - Yu-Yan Huang
AU - Yi-Ying Zhao
AU - Ke-Yu Liu
AU - Wei Kang
AU - Jin Li
AU - Ying-Chun Xu
AU - Meng Xiao
PY - 2026
DA - 2026/08/05
JO - BMC microbiology
DO - 10.1186/s12866-026-05475-w
UR - https://europepmc.org/article/MED/42972497
AB - Background Candida auris has emerged as a global public health threat, with an increasing number of outbreak events reported in Beijing, the capital city of China. This study aimed to characterize the epidemic clones currently circulating in the city through population genomic analysis, and to evaluate and optimize targeted screening strategies.Methods A total of 227 C. auris isolates were analyzed, including 106 C. auris isolates collected from 23 patients admitted to Peking Union Medical College Hospital (PUMCH) during 2021-2025, and an additional 121 Clade I C. auris genomes from 10 cities in China. Phylogenetic analysis and pairwise single nucleotide polymorphisms (SNPs) were used to determine genomic relatedness of isolates. Nosocomial screening of patients and the healthcare environment was conducted using on-site direct and enrichment culture, and a real-time PCR-based assay.Results In PUMCH, 20 out of 23 (93.40%) patients were colonized by Clade I C. auris isolates. Whole genome sequencing analysis of 173 Clade I C. auris isolates collected in Beijing revealed three major sublineages. Notably, Beijing Sublineages I and II formed phylogenetically independent clusters, whereas Beijing Sublineage III clustered with a major sublineage circulating in East China, indicating inter-regional dissemination. High-resolution pairwise SNP analysis further suggested multiple introductions into the predominant department, the medical intensive care unit at PUMCH, and provided evidence for inter-institutional transmission. Comparative analysis of screening methods demonstrated that enrichment culture increased the C. auris screen-positive rate by 18.52% (10/54) compared with using direct culture alone. Real-time PCR cycle threshold (Ct) values showed a good correlation with semi-quantitative culture results, and samples with Ct values ≤ 30 exhibited high culture positive rates compared with those with Ct values > 30, Additionally, decolonization attempts with chlorhexidine resulted in only a brief increase in Ct values, with the patient's fungal loads returning to baseline within 7 days.Conclusion Clade I C. auris isolates constituted the predominant lineage spreading in Beijing. Given that evidence of both inter-regional and inter-institutional dissemination has been collected, effective coordination and information sharing between healthcare institutions are critical. Ct value-based stratification of transmission risk may complement the limited sensitivity of culture-based methods, and support practical implementation of infection prevention and control measures.
SN - 1471-2180
ER -