Identification and antifungal resistance profiling of <i>Candida (Candidozyma) auris</i> 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.