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November 11, 2016/65(44);1234–1237. What is already known about this topic? Candida aurisis an emerging pathogenic fungus that has been reported from at least a dozen countries on four continents during 2009–2015. The organism is difficult to identify using traditional biochemical methods, some isolates have been found to be resistant to all three major classes of antifungal medications, and C. aurishas caused health care–associated outbreaks. What is added by this report? This is the first description of C. auriscases in the United States. C. aurisappears to have emerged in the United States only in the last few years, and U.S. isolates are related to isolates from South America and South Asia. Evidence from U.S. case investigations suggests likely transmission of the organism occurred in health care settings. What are the implications for public health practice? It is important that U.S. laboratories accurately identify C. aurisand for health care facilities to implement recommended infection control practices to prevent the spread of C. auris. Local and state health departments and CDC should be notified of possible cases of C. aurisand of isolates of C. haemuloniiand Candidaspp. that cannot be identified after routine testing. This report details the first U.S. cases of a new fungal infection seen primarily in immunocompromised hosts, including stem cell transplant recipients.

Two patients developed renal mucormycosis following transplantation of kidneys from the same donor, a near‐drowning victim in a motor vehicle crash. Genotypically, indistinguishable strains of Apophysomyces eleganswere recovered from both recipients. We investigated the source of the infection including review of medical records, environmental sampling at possible locations of contamination and query for additional cases at other centers. Histopathology of the explanted kidneys revealed extensive vascular invasion by aseptate, fungal hyphae with relative sparing of the renal capsules suggesting a vascular route of contamination. Disseminated infection in the donor could not be definitively established. A. eleganswas not recovered from the same lots of reagents used for organ recovery or environmental samples and no other organ transplant‐related cases were identified. This investigation suggests either isolated contamination of the organs during recovery or undiagnosed disseminated donor infection following a near‐drowning event. Although no changes to current organ recovery or transplant procedures are recommended, public health officials and transplant physicians should consider the possibility of mucormycosis transmitted via organs in the future, particularly for near‐drowning events. Attention to aseptic technique during organ recovery and processing is re‐emphasized.

Two patients developed renal mucormycosis following transplantation of kidneys from the same donor, a near‐drowning victim in a motor vehicle crash. Genotypically, indistinguishable strains of Apophysomyces eleganswere recovered from both recipients. We investigated the source of the infection including review of medical records, environmental sampling at possible locations of contamination and query for additional cases at other centers. Histopathology of the explanted kidneys revealed extensive vascular invasion by aseptate, fungal hyphae with relative sparing of the renal capsules suggesting a vascular route of contamination. Disseminated infection in the donor could not be definitively established. A. eleganswas not recovered from the same lots of reagents used for organ recovery or environmental samples and no other organ transplant‐related cases were identified. This investigation suggests either isolated contamination of the organs during recovery or undiagnosed disseminated donor infection following a near‐drowning event. Although no changes to current organ recovery or transplant procedures are recommended, public health officials and transplant physicians should consider the possibility of mucormycosis transmitted via organs in the future, particularly for near‐drowning events. Attention to aseptic technique during organ recovery and processing is re‐emphasized.