A Candidemia Case Caused by a Novel Drug-Resistant Candida auris with the Y132F Mutation in Erg11 in Mainland China

Abstract

Background Candida auris is a pathogen first found in external ear canal, becoming a major threat to global health. Here, we describe a candidemia case caused by a novel drug-resistant Candida auris strain. Case Presentation An 80-year-old patient, with multiple serious medical conditions, was suffered from candidemia caused by Candida auris , died 9 days after admission in our hospital. Phylogenetic analysis indicates that this C. auris isolate (designated BJCA003) belongs to the South Asian clade, carries the Y132F mutation in the protein Erg11. And antibiotic susceptibility test indicated that BJCA003 is resistant to fluconazole and amphotericin B, not susceptible to caspofungin. In addition, this strain has multiple colony and cellular morphologies under different culture conditions. Conclusion Strain BJCA003 is a novel drug resistant C. auris strain in mainland China, the Y132F mutation in Erg11 may attribute to fluconazole-resistance, alarming that we still face more challenges about C. auris.

First report of Candida auris in Guangdong, China: clinical and microbiological characteristics of 7 episodes of candidemia

“…In this study, both isolates (28.6%, 2/7) from Hospital B belonged to Clade I. To date, only two isolates with Clade I have been reported in mainland China, both of which were from Beijing [ 15 , 24 ]. Similar to the strain of BJCA003 recently reported by Xu et al [ 24 ], both isolates with Clade I presented Y132F mutation in the ERG11 gene and resistance to amphotericin B ( Table 3 ).…”

“…To date, only two isolates with Clade I have been reported in mainland China, both of which were from Beijing [ 15 , 24 ]. Similar to the strain of BJCA003 recently reported by Xu et al [ 24 ], both isolates with Clade I presented Y132F mutation in the ERG11 gene and resistance to amphotericin B ( Table 3 ). Phylogenetic analysis also showed that both isolates were closely related to the BJCA003 ( Figure 2 ).…”

“…Such a difference among these studies might be attributed to the limited amount of case reports and information, as well as different distributions of baseline characteristics in different populations. Table S3 listed major clinical characteristics of cases of C. auris candidemia reported in the last decade [ 7 , 24 , 26–34 , 36–45 ]. As shown in Table S3, the most commonly clinical characteristics included ICU stay, underlying medical comorbidities, invasive procedure, and recent intake of broad-spectrum antibiotics, which were also observed in most of the patients here.…”