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Identification of Molecular and Genetic Resistance Mechanisms in a Candida auris Isolate in a Tertiary Care Center in Türkiye

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Abstract

Background

Candida auris is a multidrug-resistant pathogen that causes nosocomial outbreaks and high mortality. We conducted this study to investigate the molecular mechanisms of antifungal resistance in our clinical isolate of C. auris with a high level of resistance to three main classes of antifungals.

Material and Methods

A clinical C. auris isolate was identified by MALDI-TOF MS and antifungal susceptibilities were determined by the Sensititre YeastOne YO10 panel. After sequencing the whole genome of the microorganism with Oxford Nanopore NGS Technologies, a phylogenetic tree was drawn as a cladogram to detect where the C. auris clade to this study’s assembly belongs.

Results

The C. auris isolate in this study (MaCa01) was determined to be a part of the clade I (South Asian). The resistance-related genes indicated that MaCa01 would most likely be highly resistant to fluconazole (CDR1, TAC1b, and ERG11), none or little resistant to amphotericin B (AmpB) and echinocandins, and sensitive to flucytosine. The mutations found in the above-mentioned genes in the Türkiye C. auris isolate reveals an antifungal resistance pattern. This molecular resistance pattern was found consistent with the interpretation of MIC values of the antifungals according to CDC tentative breakpoints.

Conclusion

We detected the well-known antifungal resistance mutations, responsible for azole resistance in C. auris. Despite no ERG2, ERG6, and FKS mutation identified, the isolate was found to be resistant to AmpB and caspofungin based on the CDC tentative breakpoints which could be related to unidentified mutations.

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Funding

This study was supported by Gilead Sciences.

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Authors and Affiliations

  1. Department of Infectious Disease and Clinical Microbiology, Marmara University School of Medicine, Istanbul, Türkiye

    Buket Erturk Sengel & Zekaver Odabasi

  2. Department of Bioistatistics and Medical Informatics, Graduate School of Health Sciences, Acibadem University, Istanbul, Türkiye

    Berkay Yekta Ekren & Ugur Sezerman

  3. Department of Medical Microbiology, Marmara University School of Medicine, Istanbul, Türkiye

    Elvan Sayin & Nilgun Cerikcioglu

Authors
  1. Buket Erturk Sengel
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Correspondence to Buket Erturk Sengel.

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The authors declared no potential conflicts of interest concerning this article's authorship and/or publication.

Ethical Approval

Marmara University School of Medicine Institutional Ethical Review Board issued approval 09.2021.578. The collected data did not include any patient or employee identifying information.

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Erturk Sengel, B., Ekren, B.Y., Sayin, E. et al. Identification of Molecular and Genetic Resistance Mechanisms in a Candida auris Isolate in a Tertiary Care Center in Türkiye. Mycopathologia 188, 929–936 (2023). https://doi.org/10.1007/s11046-023-00787-1

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  • DOI: https://doi.org/10.1007/s11046-023-00787-1

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