Related Experiment Video
Updated: Jan 6, 2026
Author Spotlight: Accelerating Diagnostic Accuracy with Direct Identification of Gram-Negatives from Blood Culture Bottles
Published on: May 24, 2024
External Quality Assessment Evaluating the Ability of Dutch Clinical Microbiological Laboratories to Identify Candida
Jochem B Buil1,2, Henrich A L van der Lee3,4, Ilse Curfs-Breuker5,6,7
1Department of Medical Microbiology, Radboud University Medical Center, 6525GA Nijmegen, The Netherlands. jochem.buil@radboudumc.nl.
Background:
Candida auris is a yeast that is causing nosocomial outbreaks in healthcare facilities around the world. There is a risk of the misidentification of C. auris with matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS)-when libraries are used that lack C. auris spectra, or when conventional biochemical methods are used.
Methods:
We conducted an external quality assessment to evaluate the ability of Dutch clinical microbiological laboratories to identify C. auris, and to raise awareness about the risk of misidentification.
Results:
35/47 participating laboratories were able to identify C. auris correctly. Only 2/14 labs that potentially misidentified C. auris with their primary identification methods specified that they would perform additional tests to exclude C. auris when appropriate. 45/47 labs used MALDI-TOF MS systems to identify Candida species.
Conclusions:
There was a lack of awareness about the potential misidentification of C. auris in many labs that used MALDI-TOF MS with libraries that lacked C. auris spectra, and labs that used Vitek 2. However, as the currently available MALDI-TOF MS libraries in The Netherlands contain several C. auris spectra, we expect that currently almost all participating laboratories are able to identify C. auris correctly, as 45/47 participating laboratories use MALDI-TOF MS as their primary yeast identification method.
Insights
Many clinical labs struggle to correctly identify Candida auris, a yeast causing hospital outbreaks. Improved MALDI-TOF MS libraries are enhancing identification accuracy, but awareness of potential misidentification remains crucial.
Area of Science:
- Clinical Microbiology
- Infectious Diseases
- Diagnostic Mycology
Background:
- Candida auris is an emerging multidrug-resistant yeast responsible for global nosocomial outbreaks.
- Misidentification of C. auris is a significant risk in clinical laboratories using conventional methods or MALDI-TOF MS with incomplete spectral libraries.
- Accurate identification is critical for effective infection control and patient management.
Purpose of the Study:
- To assess the proficiency of Dutch clinical laboratories in identifying Candida auris.
- To evaluate the risk of C. auris misidentification in routine laboratory diagnostics.
- To raise awareness regarding potential identification challenges and promote accurate detection.
Main Methods:
- An external quality assessment program was implemented.
- Participating laboratories' ability to identify C. auris was evaluated.
- Identification methods, including matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and Vitek 2, were assessed.
Main Results:
- 35 out of 47 (74.5%) participating laboratories correctly identified C. auris.
- Only 2 out of 14 laboratories that potentially misidentified C. auris indicated performing confirmatory tests.
- The majority of labs (45/47) utilized MALDI-TOF MS for Candida species identification.
Conclusions:
- A notable lack of awareness regarding C. auris misidentification existed among labs using specific MALDI-TOF MS libraries and Vitek 2.
- The inclusion of C. auris spectra in current MALDI-TOF MS libraries in the Netherlands is expected to improve identification rates.
- Continued vigilance and updated diagnostic protocols are essential for accurate C. auris detection in clinical settings.
More Related Videos
05:02A 1.5 Hour Procedure for Identification of Enterococcus Species Directly from Blood Cultures
Published on: February 10, 2011
07:19A 96 Well Microtiter Plate-based Method for Monitoring Formation and Antifungal Susceptibility Testing of Candida albicans Biofilms
Published on: October 21, 2010