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Fiala J, Roach T, Holzinger A, Husiev Y, Delueg L, Hammerle F, Armengol ES, Schöbel H, Bonnet S, Laffleur F, Kranner I, Lackner M, Siewert B. The Light-activated Effect of Natural Anthraquinone Parietin against Candida auris and Other Fungal Priority Pathogens. PLANTA MEDICA 2024; 90:588-594. [PMID: 38843798 PMCID: PMC11156500 DOI: 10.1055/a-2249-9110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 01/05/2024] [Indexed: 06/10/2024]
Abstract
Antimicrobial photodynamic therapy (aPDT) is an evolving treatment strategy against human pathogenic microbes such as the Candida species, including the emerging pathogen C. auris. Using a modified EUCAST protocol, the light-enhanced antifungal activity of the natural compound parietin was explored. The photoactivity was evaluated against three separate strains of five yeasts, and its molecular mode of action was analysed via several techniques, i.e., cellular uptake, reactive electrophilic species (RES), and singlet oxygen yield. Under experimental conditions (λ = 428 nm, H = 30 J/cm2, PI = 30 min), microbial growth was inhibited by more than 90% at parietin concentrations as low as c = 0.156 mg/L (0.55 µM) for C. tropicalis and Cryptococcus neoformans, c = 0.313 mg/L (1.10 µM) for C. auris, c = 0.625 mg/L (2.20 µM) for C. glabrata, and c = 1.250 mg/L (4.40 µM) for C. albicans. Mode-of-action analysis demonstrated fungicidal activity. Parietin targets the cell membrane and induces cell death via ROS-mediated lipid peroxidation after light irradiation. In summary, parietin exhibits light-enhanced fungicidal activity against all Candida species tested (including C. auris) and Cryptococcus neoformans, covering three of the four critical threats on the WHO's most recent fungal priority list.
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Affiliation(s)
- Johannes Fiala
- Department of Pharmacognosy, Institute of Pharmacy, Center for Molecular Biosciences Innsbruck, University of Innsbruck, Austria
| | - Thomas Roach
- Department of Botany, University of Innsbruck, Austria
| | | | - Yurii Husiev
- Leiden Institute of Chemistry, Leiden University, Netherlands
| | - Lisa Delueg
- Department of Pharmacognosy, Institute of Pharmacy, Center for Molecular Biosciences Innsbruck, University of Innsbruck, Austria
| | - Fabian Hammerle
- Department of Pharmacognosy, Institute of Pharmacy, Center for Molecular Biosciences Innsbruck, University of Innsbruck, Austria
| | - Eva Sanchez Armengol
- Department of Technology, Institute of Pharmacy, Center for Molecular Biosciences Innsbruck, University of Innsbruck, Austria
| | | | | | - Flavia Laffleur
- Department of Technology, Institute of Pharmacy, Center for Molecular Biosciences Innsbruck, University of Innsbruck, Austria
| | - Ilse Kranner
- Department of Botany, University of Innsbruck, Austria
| | - Michaela Lackner
- Institute of Hygiene und Medical Microbiology, Medical University of Innsbruck, Austria
| | - Bianka Siewert
- Department of Pharmacognosy, Institute of Pharmacy, Center for Molecular Biosciences Innsbruck, University of Innsbruck, Austria
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Horton MV, Holt AM, Nett JE. Mechanisms of pathogenicity for the emerging fungus Candida auris. PLoS Pathog 2023; 19:e1011843. [PMID: 38127686 PMCID: PMC10735027 DOI: 10.1371/journal.ppat.1011843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Candida auris recently emerged as an urgent public health threat, causing outbreaks of invasive infections in healthcare settings throughout the world. This fungal pathogen persists on the skin of patients and on abiotic surfaces despite antiseptic and decolonization attempts. The heightened capacity for skin colonization and environmental persistence promotes rapid nosocomial spread. Following skin colonization, C. auris can gain entrance to the bloodstream and deeper tissues, often through a wound or an inserted medical device, such as a catheter. C. auris possesses a variety of virulence traits, including the capacity for biofilm formation, production of adhesins and proteases, and evasion of innate immune responses. In this review, we highlight the interactions of C. auris with the host, emphasizing the intersection of laboratory studies and clinical observations.
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Affiliation(s)
- Mark V. Horton
- Department of Medicine, University of Wisconsin, Madison, Wisconsin, United States of America
- Department of Medical Microbiology & Immunology, University of Wisconsin, Madison, Wisconsin, United States of America
| | - Ashley M. Holt
- Department of Medicine, University of Wisconsin, Madison, Wisconsin, United States of America
- Department of Medical Microbiology & Immunology, University of Wisconsin, Madison, Wisconsin, United States of America
| | - Jeniel E. Nett
- Department of Medicine, University of Wisconsin, Madison, Wisconsin, United States of America
- Department of Medical Microbiology & Immunology, University of Wisconsin, Madison, Wisconsin, United States of America
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3
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Garcia-Bustos V, Cabañero-Navalon MD, Ruiz-Gaitán A, Salavert M, Tormo-Mas MÁ, Pemán J. Climate change, animals, and Candida auris: insights into the ecological niche of a new species from a one health approach. Clin Microbiol Infect 2023:S1198-743X(23)00132-5. [PMID: 36934871 DOI: 10.1016/j.cmi.2023.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/27/2023] [Accepted: 03/11/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND One of the most puzzling traits of Candida auris is the recent simultaneous and independent emergence of five genetically distinct clades on three continents. Global warming has been proposed as a contributing factor for this emergence due to C. auris high thermotolerance compared to phylogenetically close Candida species. This hypothesis postulates that climate change induced an environmental ancestor to become pathogenic through thermal adaptation and was then globally disseminated by an intermediate host. OBJECTIVES The aim of this review is to compile the current knowledge on the emergence and ecological environmental niches of C. auris, and highlight the potential role of animals in transmission. SOURCES A literature search was conducted using PubMed, MEDLINE, Google Scholar, and Web of Science from May 2022 to January 2023. CONTENT We discuss the up-to-date data on the ecological niches of this fungus and its mechanisms of emergence, transmission cycle in nature, and worldwide dissemination. We highlight the possibility of an originally intermediate host possibly related to marine or freshwater ecosystems on the basis of recent molecular and microbiological evidence from a One Health perspective. The consequences of harmful human impacts on the environment in the raise of new fungal pathogenic species such as C. auris are also analysed and compared to other animal precedents. IMPLICATIONS The present knowledge can prompt the generation of new evidence on the ecological reservoirs of C. auris and its original mechanisms of environmental or interspecies transmission. Further research on the highlighted gaps will help to understand the importance of the relationships between human, animal, and ecosystem health, as factors involved in the raise and spread of emerging fungal pathogenic species.
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Affiliation(s)
- Victor Garcia-Bustos
- Severe Infection Research Group, Health Research Institute La Fe, Valencia, Spain; Department of Infectious Diseases, University and Polytechnic La Fe Hospital, Valencia, Spain
| | | | - Alba Ruiz-Gaitán
- Severe Infection Research Group, Health Research Institute La Fe, Valencia, Spain; Department of Medical Microbiology, University and Polytechnic La Fe Hospital, Valencia, Spain.
| | - Miguel Salavert
- Severe Infection Research Group, Health Research Institute La Fe, Valencia, Spain; Department of Infectious Diseases, University and Polytechnic La Fe Hospital, Valencia, Spain
| | | | - Javier Pemán
- Severe Infection Research Group, Health Research Institute La Fe, Valencia, Spain
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Candida auris as an Emergent Public Health Problem: A Current Update on European Outbreaks and Cases. Healthcare (Basel) 2023; 11:healthcare11030425. [PMID: 36767000 PMCID: PMC9914380 DOI: 10.3390/healthcare11030425] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/26/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
Candida auris is considered to be an emerging fungal pathogen and is related to high mortality rates, persistent candidemia, inconsistencies in susceptibility testing results and misidentification by available commercial identification systems. Multidrug-resistant (MDR) and pandrug-resistant (PDR) strains are increasingly detected. In Europe, hospital outbreaks caused by C. auris have been reported in the United Kingdom (UK), Italy and Spain; however, several cases have been sporadically detected in all European countries. C. auris is difficult to control despite enhanced control measures due to its ability to survive for a long time in environments and colonize patients for prolonged periods. An adequate laboratory diagnostic capacity and national surveillance are fundamental to rapidly detect new C. auris cases and to apply the correct measures to circumscribe them and prevent their spread. Our narrative review aims to highlight the primary C. auris outbreaks and case reports that have occurred in Europe.
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Ashkenazi-Hoffnung L, Rosenberg Danziger C. Navigating the New Reality: A Review of the Epidemiological, Clinical, and Microbiological Characteristics of Candida auris, with a Focus on Children. J Fungi (Basel) 2023; 9:176. [PMID: 36836291 PMCID: PMC9963988 DOI: 10.3390/jof9020176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/22/2023] [Accepted: 01/26/2023] [Indexed: 02/03/2023] Open
Abstract
During the past decade, Candida auris emerged across the world, causing nosocomial outbreaks in both pediatric and adult populations, particularly in intensive care settings. We reviewed the epidemiological trends and the clinical and microbiological characteristics of C. auris infection, focusing on the pediatric population. The review is based on 22 studies, which included about 250 pediatric patients with C. auris infection, across multiple countries; neonates and premature babies were the predominant pediatric patient group affected. The most common type of infection reported was bloodstream infection, which was associated with exceptionally high mortality rates. Antifungal treatment varied widely between the patients; this signifies a serious knowledge gap that should be addressed in future research. Advances in molecular diagnostic methods for rapid and accurate identification and for detection of resistance may prove especially valuable in future outbreak situations, as well as the development of investigational antifungals. However, the new reality of a highly resistant and difficult-to-treat pathogen calls for preparedness of all aspects of patient care. This spans from laboratory readiness, to raising awareness among epidemiologists and clinicians for global collaborative efforts to improve patient care and limit the spread of C. auris.
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Affiliation(s)
- Liat Ashkenazi-Hoffnung
- Department of Day Hospitalization and Pediatric Infectious Diseases Unit, Schneider Children’s Medical Center, Petach Tikva 4920235, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel
| | - Chen Rosenberg Danziger
- Department of Day Hospitalization, Schneider Children’s Medical Center, Petach Tikva 4920235, Israel
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Crawford LC, Kidd SE, Anninos TM, Turra M, Weldhagen GF. Candida auris PCR for high throughput screening. Med Mycol 2022; 60:6655997. [PMID: 35927750 DOI: 10.1093/mmy/myac057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/03/2022] [Accepted: 07/22/2022] [Indexed: 11/14/2022] Open
Abstract
Candida auris has significant implications for infection control due to its multidrug resistance and spread in healthcare settings. Current culture-based screening methods are laborious and risks muco-cutaneous colonisation of laboratory staff. We describe the adaptation of a published real-time PCR for the identification of C. auris in skin swabs for high throughput infection control screening. Two published primer and probe sets were analysed utilising serial 10-fold dilutions of fifteen C. auris strains to assess the PCR limit of detection. One primer and probe set was compatible with our laboratory workflow and was selected for further development yielding a limit of detection of 1 colony forming unit (CFU) per reaction. Non-C. auris isolates, as well as routine skin swabs (n = 100) were tested by culture and PCR to assess specificity, where no cross-reactivity was detected. Skin swabs from a proven C. auris case (n = 6) were all both culture positive and PCR positive, while surveillance swabs from close contacts (n = 46) were all both culture negative and PCR negative. Finally, use of a lysis buffer comprising 4 M guanidinium thiocyanate rendered swab-equivalent quantities of C. auris non-viable, providing assurance of the safety benefit of PCR over culture. The development of a PCR assay for high throughput infection control screening is a promising method for rapid detection of C. auris with utility in an outbreak setting.
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Affiliation(s)
- Lucy C Crawford
- Microbiology and Infectious Diseases, SA Pathology, Adelaide, SA, Australia
| | - Sarah E Kidd
- Microbiology and Infectious Diseases, SA Pathology, Adelaide, SA, Australia.,National Mycology Reference Centre (NMRC), SA Pathology, Adelaide, SA, Australia
| | - Terry M Anninos
- Microbiology and Infectious Diseases, SA Pathology, Adelaide, SA, Australia
| | - Mark Turra
- Epidemiology and Public Health Laboratory, SA Pathology, Adelaide, SA, Australia
| | - Gerhard F Weldhagen
- National Mycology Reference Centre (NMRC), SA Pathology, Adelaide, SA, Australia
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Desoubeaux G, Coste AT, Imbert C, Hennequin C. Overview about Candida auris: What's up 12 years after its first description? J Mycol Med 2022; 32:101248. [DOI: 10.1016/j.mycmed.2022.101248] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 01/04/2022] [Accepted: 01/19/2022] [Indexed: 12/18/2022]
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8
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Keighley C, Cooley L, Morris AJ, Ritchie D, Clark JE, Boan P, Worth LJ. Consensus guidelines for the diagnosis and management of invasive candidiasis in haematology, oncology and intensive care settings, 2021. Intern Med J 2021; 51 Suppl 7:89-117. [DOI: 10.1111/imj.15589] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Caitlin Keighley
- Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney Camperdown New South Wales Australia
- Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR, New South Wales Health Pathology Westmead New South Wales Australia
- Southern IML Pathology, Sonic Healthcare Coniston New South Wales Australia
| | - Louise Cooley
- Department of Microbiology and Infectious Diseases Royal Hobart Hospital Hobart Tasmania Australia
- University of Tasmania Hobart Tasmania Australia
| | - Arthur J. Morris
- LabPLUS, Clinical Microbiology Laboratory Auckland City Hospital Auckland New Zealand
| | - David Ritchie
- Department of Clinical Haematology Peter MacCallum Cancer Centre and Royal Melbourne Hospital Melbourne Victoria Australia
| | - Julia E. Clark
- Department of Infection Management Queensland Children's Hospital, Children's Health Queensland Brisbane Queensland Australia
- Child Health Research Centre The University of Queensland Brisbane Queensland Australia
| | - Peter Boan
- PathWest Laboratory Medicine WA, Department of Microbiology Fiona Stanley Fremantle Hospitals Group Murdoch Western Australia Australia
- Department of Infectious Diseases Fiona Stanley Fremantle Hospitals Group Murdoch Western Australia Australia
| | - Leon J. Worth
- National Centre for Infections in Cancer, Peter MacCallum Cancer Centre Melbourne Victoria Australia
- Department of Infectious Diseases Peter MacCallum Cancer Centre Melbourne Victoria Australia
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9
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Echinocandins as Biotechnological Tools for Treating Candida auris Infections. J Fungi (Basel) 2020; 6:jof6030185. [PMID: 32971857 PMCID: PMC7558506 DOI: 10.3390/jof6030185] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/06/2020] [Accepted: 09/09/2020] [Indexed: 12/30/2022] Open
Abstract
Candida auris has been reported in the past few years as an invasive fungal pathogen of high interest. Its recent emergence in healthcare-associated infections triggered the efforts of researchers worldwide, seeking additional alternatives to the use of traditional antifungals such as azoles. Lipopeptides, specially the echinocandins, have been reported as an effective approach to control pathogenic fungi. However, despite its efficiency against C. auris, some isolates presented echinocandin resistance. Thus, therapies focused on echinocandins’ synergism with other antifungal drugs were widely explored, representing a novel possibility for the treatment of C. auris infections.
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10
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Biswas C, Wang Q, van Hal SJ, Eyre DW, Hudson B, Halliday CL, Mazsewska K, Kizny Gordon A, Lee A, Irinyi L, Heath CH, Chakrabarti A, Govender NP, Meyer W, Sintchenko V, Chen SCA. Genetic Heterogeneity of Australian Candida auris Isolates: Insights From a Nonoutbreak Setting Using Whole-Genome Sequencing. Open Forum Infect Dis 2020; 7:ofaa158. [PMID: 32500091 PMCID: PMC7255648 DOI: 10.1093/ofid/ofaa158] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 04/29/2020] [Indexed: 11/13/2022] Open
Abstract
Whole-genome sequencing clustered Australian Candida auris isolates from sporadic cases within clade III. Case isolates were genomically distinct; however, unexpectedly, those from 1 case comprised 2 groups separated by >60 single nucleotide polymorphisms (SNPs) with no isolate being identical, in contrast to outbreaks where isolates from any 1 individual have differed by <3 SNPs. Multidrug resistance was absent. High within-host genetic heterogeneity should be considered when investigating C. auris infections.
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Affiliation(s)
- Chayanika Biswas
- Centre for Infectious Diseases and Microbiology - Public Health, Westmead Hospital, The University of Sydney, Sydney, Australia.,Center for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Sydney, Australia
| | - Qinning Wang
- Centre for Infectious Diseases and Microbiology - Public Health, Westmead Hospital, The University of Sydney, Sydney, Australia.,Center for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Sydney, Australia
| | - Sebastiaan J van Hal
- Deparment of Infectious Diseases and Microbiology, New South Wales Health Pathology, The Royal Prince Alfred Hospital, Sydney, Australia
| | - David W Eyre
- Big Data Institute, University of Oxford, Oxford, United Kingdom
| | - Bernard Hudson
- Department of Microbiology, Royal North Shore Hospital, New South Wales Health Pathology, Sydney, Australia
| | - Catriona L Halliday
- Center for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Sydney, Australia.,Marie Bashir Institute for Emerging Infections and Biosecurity, The University of Sydney, Sydney, Australia
| | - Krystyna Mazsewska
- Marie Bashir Institute for Emerging Infections and Biosecurity, The University of Sydney, Sydney, Australia.,Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Faculty of Medicine and Health, Westmead Clinical School and the Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia
| | - Alice Kizny Gordon
- Department of Microbiology, Royal North Shore Hospital, New South Wales Health Pathology, Sydney, Australia
| | - Andie Lee
- Deparment of Infectious Diseases and Microbiology, New South Wales Health Pathology, The Royal Prince Alfred Hospital, Sydney, Australia
| | - Laszlo Irinyi
- Marie Bashir Institute for Emerging Infections and Biosecurity, The University of Sydney, Sydney, Australia.,Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Faculty of Medicine and Health, Westmead Clinical School and the Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia
| | - Christopher H Heath
- Department of Microbiology, Fiona Stanley Hospital Network, PathWest Laboratory Medicine, and the Department of Infectious Diseases, Fiona Stanley Hospital, Perth, Australia
| | - Arunaloke Chakrabarti
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Nelesh P Govender
- National Institute for Communicable Diseases, Division of the National Health Laboratory Service and Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Wieland Meyer
- Centre for Infectious Diseases and Microbiology - Public Health, Westmead Hospital, The University of Sydney, Sydney, Australia.,Department of Microbiology, Royal North Shore Hospital, New South Wales Health Pathology, Sydney, Australia.,Marie Bashir Institute for Emerging Infections and Biosecurity, The University of Sydney, Sydney, Australia
| | - Vitali Sintchenko
- Centre for Infectious Diseases and Microbiology - Public Health, Westmead Hospital, The University of Sydney, Sydney, Australia.,Center for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Sydney, Australia.,Department of Microbiology, Royal North Shore Hospital, New South Wales Health Pathology, Sydney, Australia
| | - Sharon C-A Chen
- Centre for Infectious Diseases and Microbiology - Public Health, Westmead Hospital, The University of Sydney, Sydney, Australia.,Center for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Sydney, Australia.,Department of Microbiology, Royal North Shore Hospital, New South Wales Health Pathology, Sydney, Australia.,Marie Bashir Institute for Emerging Infections and Biosecurity, The University of Sydney, Sydney, Australia
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