Circulation of fluconazole-resistant Candida auris in Peru confirmed by genomic analysis.

BACKGROUND

Candida auris is an emerging fungal pathogen associated with invasive infections, notable for nosocomial spread and multidrug resistance. Despite its public health importance, genetic data from Peruvian isolates remain limited.

OBJECTIVES

To perform a multi-isolate genomic analysis of Peruvian C. auris isolates, including epidemiological analysis, clade assignment, phylogenetic reconstruction, and characterisation of antifungal resistance-associated mutations.

METHODS

Twenty clinical samples from hospitals in Lima and Callao were identified using MALDI-TOF and subjected to antifungal susceptibility testing. Genomic DNA was sequenced, and genomes meeting quality criteria (n = 19) were included in the analysis. Phylogenomic and ERG11 phylogenetic analyses were performed, and protein modelling combined with molecular docking was used to assess interactions with lanosterol 14-α-demethylase.

FINDINGS: All analysed isolates belonged to clade IV and exhibited resistance to fluconazole. The ERG11 gene harboured four relevant mutations; notably, K143R was located within the hemi-binding region of lanosterol 14-α-demethylase and was predicted, based on molecular docking, to potentially alter fluconazole binding. These findings highlight the circulation of a resistant clade and underscore the need for strengthened genomic surveillance and antifungal stewardship strategies.

MAIN

CONCLUSIONS

This study expands the genomic data available for C. auris and reinforces the urgent need for sustained genomic surveillance to monitor and contain antifungal resistance.