Candida auris

Background

Microbiology

• Species of yeast within the genus Candida that is notable for its high risk of multidrug resistance
• Separated into four geographic clades: South Asian, South African, South America, and East Asian
• Related to Candida haemulonii

Epidemiology

• First reported in Japan in 2009, now found worldwide
• Associated with nosocomial outbreaks particularly in ICU

Clinical Manifestations

• Similar to any other species of Candida
• Most importantly, it is a cause of fungemia in patients admitted to ICU

Diagnosis

• Earlier automated systems could misidentify it as: Candida famata, Candida haemolunii, Rhodotorula glutinis, Candida sake, Candida catenulate, Candida lusitaniae, Candida guilliermondii, Candida parapsilosis, Candida albicans, Candida tropicalis, and in one MALDI-TOF Neisseria meningitidis or Pseudomonas rhizosphaerae

Management

• First-line treatment is with echinocandins, though resistance is growing
• Common but not universally resistant to fluconazole, and reduced susceptibility to other azoles, including voriconazole, itraconazole, isavuconazole
• Variable susceptibility to amphotericin B