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Candida auris, Molecular Detection

The molecular detection for Candida auris is used for the immediate, with high specificity and sensitivity laboratory diagnosis of the fungus (yeast) in various biological materials. Molecular testing for Candida auris is included in the 14 different species of Yeast-like Fungi, Molecular Detection MycoScreen™.

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Candida auris is a newly emerged member of the Candida/Clavispora clade, first isolated in Japan in 2009 from the ear discharge of a female patient. In the past decade, infections caused by C. auris have become a global threat due to its rapid emergence worldwide and multidrug resistance properties.

C. auris has been isolated from multiple infection sites throughout the body and is generally hospital-acquired. C auris isolated from urine, bile, blood, wounds, the nares, the axilla, the skin, and the rectum of infected individuals. Unlike C. albicans, which colonizes the gastrointestinal and genitourinary tracts of the most healthy individuals, C. auris is hypothesized to predominantly colonize the skin; however, in rare instances, it has been isolated from the gut, oral, and esophageal mucosa of infected individuals. Consistent with the rarity of isolating C. auris in the gut, clinical manifestations and in vivo experiments together suggest that C. auris is incapable of colonizing anaerobic environments like the gut. In terms of the oral mucosa, a recent study found that the salivary antimicrobial peptide histatin 5 has a potent antifungal effect on C. auris. This peptide may limit the colonization of C. auris in the oral mucosa and explain with it is rarely isolated from this area. In clinical settings, C. auris is most commonly associated with bloodstream infections. Invasive infections caused by C. auris occur more frequently in critically ill patients in ICUs. Similar to other invasive Candida infections, invasive C. auris infections are associated with high global mortality rates ranging from 30 to 60%.

Risk factors for C. auris infections are similar to those for other Candida species. This is not surprising given that many Candida species are opportunistic pathogens and are primarily associated with critically ill and immunocompromised patients. Risk factors for C. auris infections include elderly age, diabetes mellitus, recent surgery, the presence of an indwelling medical device (e.g., central venous catheter), an immunosuppressed state, the use of hemodialysis, a neutropenic state, chronic renal disease, or the use of broad-spectrum antibiotic and/or antifungal drugs.

One important reason that C. auris is considered to be a “superbug” and is increasingly becoming a threat to human health is its intrinsic resistance to one or more classes of antifungal drugs available in the clinic. Based on the conservative antifungal drug breakpoints for C. albicans and other Candida species, most isolates of C. auris are resistant to fluconazole. A subset of C. auris isolates has high minimum inhibitory concentrations (MICs) than that of amphotericin B and echinocandin compounds, and some C. auris strains are resistant to all available classes of antifungal drugs.

Candida auris characteristics

  • The causative agent of catheter-associated infection and invasive candidiasis
  • Associated with urinary tract infections, otitis media, surgical wound infections, skin abscesses (associated with catheter insertion), myocarditis, meningitis, bone tissue infections, and wound infections
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