Navigating the molecular landscape of Candida auris in a tertiary care setting in Eastern India.

PURPOSE: Candida auris was recently listed as a critical priority fungal pathogen by WHO due to its multidrug resistance and enhanced propensity for nosocomial transmission. This study investigated the molecular epidemiology and colonization patterns of C. auris in a tertiary care center in Eastern India.

METHODS

A total of 201 patients from different intensive care units (ICUs) were enrolled, with colonization rates determined through enrichment followed by culture on chromogenic agar and molecular confirmation using Candida auris specific polymerase chain reaction (PCR) and antifungal susceptibility testing was done using microbroth dilution. For molecular characterization Fluorescent Amplified Fragment Polymorphism (FAFLP) was used.

RESULTS

FAFLP revealed multiple clusters of strains, predominantly belonging to clade I, with notable isolates closely associated with clades III, IV, and V, previously unreported in India. Antifungal susceptibility testing found high resistance to amphotericin B (59.6 %) and low resistance to fluconazole compared to older studies (59.6 %), underscoring the need for further investigation. Sustained transmission of C. auris was observed despite infection control measures, emphasizing the ongoing challenges in infection control and the necessity for continuous surveillance.

CONCLUSION

This study contributes valuable insights into the epidemiology and genetic diversity of C. auris in Eastern India, highlighting the need for further investigations to understand transmission dynamics and clinical implications and underscores the importance of ongoing surveillance in combating this emerging pathogen.