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Case Reports
. 2024 Sep 27;12(10):1962.
doi: 10.3390/microorganisms12101962.

First Case of Candida Auris Sepsis in Southern Italy: Antifungal Susceptibility and Genomic Characterisation of a Difficult-to-Treat Emerging Yeast

Stefania Stolfa  1 , Giuseppina Caggiano  2   3 , Luigi Ronga  1 , Lidia Dalfino  4 , Francesca Centrone  3 , Anna Sallustio  3 , Davide Sacco  2 , Adriana Mosca  1 , Monica Stufano  4 , Annalisa Saracino  5 , Nicolo' De Gennaro  5 , Daniele Casulli  3 , Nicola Netti  3 , Savino Soldano  6 , Maria Faggiano  7 , Daniela Loconsole  2   3 , Silvio Tafuri  2   3 , Salvatore Grasso  4 , Maria Chironna  1   2   3
Affiliations
Case Reports

First Case of Candida Auris Sepsis in Southern Italy: Antifungal Susceptibility and Genomic Characterisation of a Difficult-to-Treat Emerging Yeast

Stefania Stolfa et al. Microorganisms. .

Abstract

Candida auris is an emerging yeast considered a serious threat to global health. We report the first case of C. auris candidemia in Southern Italy, characterized using whole genome sequencing (WGS), and compared with a second strain isolated from a patient who presented as C. auris-colonized following screening. The C. auris strain was isolated from clinical samples, identified via MALDI-TOF, and subjected to WGS. Antifungal susceptibility testing was performed using commercial broth microdilution plates, and resistance protein sequences were evaluated with TBLASTN-2.15.0. Following the initial C. auris isolation from patient A, active surveillance and environmental investigations were implemented for all ICU patients. Of the 26 ICU surfaces sampled, 46.1% tested positive for C. auris via real-time PCR. Screening identified a second patient (patient B) as C. auris-colonized. The phylogenetic characterization of strains from patients A and B, based on the D1/D2 region of the 28s rDNA and the internal transcribed spacer (ITS) region, showed high similarity with strains from Lebanon. SNP analysis revealed high clonality, assigning both strains to clade I, indicating a significant similarity with Lebanese strains. This case confirms the alarming spread of C. auris infections and highlights the need for stringent infection control measures to manage outbreaks.

Keywords: Candida auris; infection control; phylogenesis; whole-genome sequencing.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Neighbor-joining phylogenetic tree (max. seq. difference 0.75) on the partial D1/D2 large subunit (LSU) rDNA sequence of C. auris was constructed using 101 sequences. Sequences BA02 (from patient A) and BA03 (from patient B) are shown in red.
Figure 2
Figure 2
Neighbor-joining phylogenetic tree (max. seq. difference 0.75) on the internal transcribed spacer (ITS) sequence of C. auris was constructed using 101 sequences. Sequences BA02 (from patient A) and BA03 (from patient B) are shown in red.
Figure 3
Figure 3
Six-clade population structure of C. auris using 139 genomes represented in the phylogenetic tree. The tree was generated by the maximum-likelihood method and annotated in iTOL. Numbers above branches are bootstrap values (only values >80 are shown). The strains of the present study are indicated in red.
See this image and copyright information in PMC

References

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