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. 2022 Jan 25:12:770635.
doi: 10.3389/fmicb.2021.770635. eCollection 2021.

Molecular Characterization of Candida auris Isolates at a Major Tertiary Care Center in Lebanon

Lina Reslan  1 , George F Araj  1   2 , Marc Finianos  3 , Rima El Asmar  2 , Jaroslav Hrabak  3 , Ghassan Dbaibo  1   4 , Ibrahim Bitar  3
Affiliations

Molecular Characterization of Candida auris Isolates at a Major Tertiary Care Center in Lebanon

Lina Reslan et al. Front Microbiol. .

Abstract

Background: The globally emerging Candida auris pathogens poses heavy burden to the healthcare system. Their molecular analyses assist in understanding their epidemiology, dissemination, treatment, and control. This study was warranted to describe the genomic features and drug resistance profiles using whole genome sequencing (WGS) among C. auris isolates from Lebanon.

Methods: A total of 28 C. auris clinical isolates, from different hospital units, were phenotypically identified by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) and tested for antifungal resistance using Vitek-2 system and E test. The complete genomes were determined by WGS using long reads sequencing (PacBio) to reveal the clade distribution and antifungal resistance genes.

Results: Candida auris revealed uniform resistance to fluconazole and amphotericin B, with full susceptibility to echinocandins. Among key resistance genes studied, only two mutations were detected: Y132F in ERG11 gene and a novel mutation, D709E, found in CDR1 gene encoding for an ABC efflux pump. Phylogenetically, C. auris genomes belonged to South Asian clade I and showed limited genetic diversity, suggesting person to person transmission.

Conclusion: This characterization of C. auris isolates from Lebanon revealed the exclusivity of clade I lineage together with uniform resistance to fluconazole and amphotericin B. The control of such highly resistant pathogen necessitates an appropriate and rapid recovery and identification to contain spread and outbreaks.

Keywords: Candida auris; Lebanon; South Asian clade; antifungal resistance; whole-genome sequencing.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Phylogenetic tree of C. auris genomes, including 28 from the present study and 80 publicly available from the NCBI database. The outer most perimeter represents the five clades geographic distribution: clade I (red), clade II (purple), clade III (green), clade IV (electric blue), and clade V (black). The leaf labels indicate the strains’ ID and colored according to the geographic origin of each strain. Our 28 isolates from Lebanon fall in clade I.
See this image and copyright information in PMC

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