Candida auris: From Multidrug Resistance to Pan-Resistant Strains

Figures & data

Figure 1 Countries from which Candida auris cases have been reported, as of December 31, 2019.

Notes: Reproduced from CDC. Candida auris: A Drug-resistant Germ That Spreads in Healthcare Facilities. Available at: https://www.cdc.gov/fungal/candida-auris/tracking-c-auris.html. Accessed on 15 January 2020.⁸ Content source: Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Foodborne, Waterborne, and Environmental Diseases (DFWED). Use of the material, including any links to the materials on the CDC, ATSDR or HHS websites, does not imply endorsement by CDC, ATSDR, HHS or the United States Government; reference to specific commercial products, manufacturers, companies, or trademarks does not constitute its endorsement or recommendation by the US Government, Department of Health and Human Services, or Centers for Disease Control and Prevention. The material is otherwise available on the agency website for no charge.

Table 1 Identification of Candida auris by Different Diagnostic Methods

Tests Which Misidentify C. auris as OtherCandida Species^Citation1,Citation28,Citation30-32,Citation55	Tests Which Correctly Identify C. auris^Citation33,Citation34
API 20CAUX	Bruker Biotyper MALDI-TOF (RUO libraries (v 2014[5627] and CA system library (v claim4))
API Candida	bioMerieux VITEK MS MALDI-TOF (ROU library (Saramis v 4.14))
Phoenix (BD Diagnostics)	VITEK 2 YST (Software v 8.01)
Vitek	Polymerase chain reaction (PCR)
MicroScan (Beckman Coulter)	Amplified fragment length polymorphism fingerprinting
Vitek MS (bioMerieux)

Table 2 Mechanism of Antifungal Resistance by C. auris

Antifungal	Resistance Mechanism	References
Polyenes	Mutations, 5 SNPs in different genome loci	[^Citation28,Citation56]
Azoles	Point mutations in the lanosterol 14 α-demethylase (ERG11) gene	[^Citation21,Citation24,Citation57]
	ERG 11 up-regulation due to mutation in Upc2 TF
	Up-regulation of efflux pump genes
Nucleoside analogs	Amino acid substitution (F211) in FUR1	[^Citation58]
Echinocandin	Mutation in FKS1/2 gene	[^Citation10]

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