Evidence map›Paper›PMID 29593275›Full record

ArticleEmerging microbes & infections2018

Genomic epidemiology of the UK outbreak of the emerging human fungal pathogen Candida auris.

Johanna Rhodes, Alireza Abdolrasouli, Rhys A Farrer, Christina A Cuomo, David M Aanensen, Darius Armstrong-James, Matthew C Fisher, Silke Schelenz

Erratum issuedOpen access · goldAbstract read
In one paragraph

Article in Emerging microbes & infections, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 174 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
174citing papers in PubMed, 1 pooled it
19.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

174 citing papers in PubMed, 1 synthesis or guideline pooled it, 242 citations in OpenAlex.

  1. Pooled it
  2. Pharmacological advances inJournal of enzyme inhibition and medicinal chemistry · 2026
    Review
  3. Review
  4. Article
  5. Emergence and Comparative Analysis ofJournal of fungi (Basel, Switzerland) · 2026
    Article
  6. Article
  7. Article
  8. Genomic landscape ofEuro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2026
    Article
  9. Microbiology spectrum · 2026
    Article
  10. Deciphering the multidrug resistance paradigm inAntimicrobial agents and chemotherapy · 2026
    Review
  11. Article
  12. bioRxiv : the preprint server for biology · 2026
    Article
  13. Resistance gene mutations and phylogenetic relationships inFrontiers in cellular and infection microbiology · 2026
    Article
  14. Functional characterization ofFrontiers in microbiology · 2026
    Article
  15. Review
  16. Article
  17. Article
  18. mSphere · 2025
    Article
  19. Article
  20. Observational

114 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 2 countries.

Johanna RhodesDepartment of Infectious Disease Epidemiology, Imperial College London, London, W2 1PG, UK. Johanna.Rhodes@imperial.ac.uk.
Alireza AbdolrasouliNational Heart and Lung Institute, Imperial College London, London, SW3 6LR, UK. S.Schelenz@rbht.nhs.uk.
Rhys A FarrerDepartment of Infectious Disease Epidemiology, Imperial College London, London, W2 1PG, UK.
Christina A CuomoBroad Institute of MIT and Harvard, Cambridge, MA, 02142, USA.
David M AanensenDepartment of Infectious Disease Epidemiology, Imperial College London, London, W2 1PG, UK.
Darius Armstrong-JamesNational Heart and Lung Institute, Imperial College London, London, SW3 6LR, UK.
Matthew C FisherDepartment of Infectious Disease Epidemiology, Imperial College London, London, W2 1PG, UK.
Silke SchelenzNational Heart and Lung Institute, Imperial College London, London, SW3 6LR, UK.
Imperial College London · GBBroad Institute · USThe London College · GBWellcome Trust · GB

Funding

Viral Genomics: evolution, spread, and host interactionsU19AI110818 · NIAID · BROAD INSTITUTE, INC. · PI CUOMO, CHRISTINA A · 2014 to 2024
$66.5M
Medical Research Council MR/K000373/1NIAID NIH HHS U19 AI110818Wellcome Trust
6 · The paper itself

Abstract

Candida auris was first described in 2009, and it has since caused nosocomial outbreaks, invasive infections, and fungaemia across at least 19 countries on five continents. An outbreak of C. auris occurred in a specialized cardiothoracic London hospital between April 2015 and November 2016, which to date has been the largest outbreak in the UK, involving a total of 72 patients. To understand the genetic epidemiology of C. auris infection both within this hospital and within a global context, we sequenced the outbreak isolate genomes using Oxford Nanopore Technologies and Illumina platforms to detect antifungal resistance alleles and reannotate the C. auris genome. Phylogenomic analysis placed the UK outbreak in the India/Pakistan clade, demonstrating an Asian origin; the outbreak showed similar genetic diversity to that of the entire clade, and limited local spatiotemporal clustering was observed. One isolate displayed resistance to both echinocandins and 5-flucytosine; the former was associated with a serine to tyrosine amino acid substitution in the gene FKS1, and the latter was associated with a phenylalanine to isoleucine substitution in the gene FUR1. These mutations add to a growing body of research on multiple antifungal drug targets in this organism. Multiple differential episodic selection of antifungal resistant genotypes has occurred within a genetically heterogenous population across this outbreak, creating a resilient pathogen and making it difficult to define local-scale patterns of transmission and implement outbreak control measures.

Indexed as

Disease OutbreaksGenomicsAllelesAmino Acid SubstitutionAntifungal AgentsCandidaCandidiasisCommunicable Diseases, EmergingCross InfectionDrug Resistance, Multiple, FungalGenome, FungalHigh-Throughput Nucleotide SequencingHumansIndiaMicrobial Sensitivity TestsMutationAntifungal Agents

Identifiers

PMID29593275
PMCPMC5874254
OpenAlexW2794692961

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.