Background: Candida auris is an emerging multi-drug resistant pathogen with high mortality rate, several cases and nosocomial infections have been reported worldwide causing a major challenge for clinicians and microbiological laboratories.
Objectives: The study aim to, describe new cases of C. auris from different sites of infection confirmed by MALDI TOF MS and ribosomal sequencing, develop the phylogenetic analysis of these isolates, detect resistant strains of C. auris to both azole and echinocandin by amplification of ERG11 and FKS1 genes.
Methods: A total of six specimens were collected from blood, urine, ear swab and groin screening sample during the period from November 2018 to March 2019. Isolates were incubated for 48 hours on Sabroud agar at 42℃, then confirmed by Matrix-Assisted Laser Desorption/Ionization-Time of Flight mass spectrometry (MALDI-TOF MS). Sequences of 18S rRNA gene from isolates and phylogenetic analysis were performed. Finally, molecular analysis of resistance genes was performed to detect the efficacy of treatment.
Results: Clinical isolates were identified by the growth on Sabroud agar at 42℃ and confirmed by MALDI-TOF MS analysis. Evolutionary analyses were conducted in MEGA7 and sequences of 18S rRNA gene were submitted to GenBank. All samples were positive for both ERG11 and FKS1 which confer azole- and echinocandin-resistant strains.
Conclusions: This study shed light on a public health threat of an emerging pathogen. Therefore, the hospital implemented strict contact screening and infection control precautions to prevent C. auris infection. Finally, there is a critical need to monitor the antifungal resistance in different geographical areas and implementation of efficient guidelines for treatment.