Identification and antifungal resistance profiling of Candida (Candidozyma) auris in a tertiary hospital in Istanbul, Türkiye.

BACKGROUND

Candida (Candidozyma) auris is a high priority fungal pathogen due to its antifungal resistance and its association with increased morbidity and mortality in infected patients.

OBJECTIVES

The aim of this study was to identify Candida species in clinical samples and to determine the clades and in vitro antifungal resistance of C. auris.

DESIGN

Retrospective cohort.

SETTINGS: Single-center tertiary hospital in Türkiye.

MATERIAL AND

METHODS

The study was conducted in the Medical Microbiology Laboratory of Ümraniye Training and Research Hospital between December 2023 and October 2024. Fungal samples were identified using bio-Mérieux VITEK MS v.3.2 (bio-Mérieux, France) and RT-PCR. Antifungal susceptibility testing of C. auris was performed by VITEK 2 Compact AST YS08 and SYO.

MAIN OUTCOME MEASURES: Identification of Candida species, in-vitro antifungal resistance of C. auris.

SAMPLE SIZE: 846 fungal isolates obtained from 746 patients were included.

RESULTS

A total of 846 fungal isolates were identified, with C. albicans being the most common (n=440, 52%), followed by Nakaseomyces glabratus (n=124, 14.7%), C. parapsilosis (n=85, 10.1%), C. tropicalis (n=69, 8.2%) and C. auris (n=57, 6.7%). All C. auris isolates were susceptible to anidulafungin. Of these isolates, 47 (82%) were resistant to fluconazole, 34 (60%) to amphotericin B, four (7%) to caspofungin and three (5%) to micafungin. One isolate was resistant to amphotericin B, fluconazole, caspofungin and micafungin. A total of 31 (54%) isolates were resistant to amphotericin B and fluconazole. In accordance with the manufacturer's recommendations, 57 isolates were evaluated as Clade-1.

CONCLUSION

C. auris infections are becoming increasingly common. In order to better understand antifungal-resistance of this pathogen, advanced methods should be used for rapid detection of clades and mutations in the FKS gene should be revealed.

LIMITATIONS: Single center, whole genome sequence analysis were not performed.