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Candida auris and some Candida parapsilosis strains exhibit similar characteristics on CHROMagarTMCandida Plus
Natalia Sasoni1, Melani Maidana1, María Gabriela Latorre-Rapela1
1Laboratorio de Micología y Diagnóstico Molecular - Cátedra de Parasitología y Micología - Facultad de Bioquímica - Universidad Nacional del Litoral - Ciudad Universitaria - Santa Fe (CP 3000) - Argentina.
Abstract:
Candida auris is considered a public health problem due to its resistance and its tendency to cause nosocomial outbreaks. CHROMagarTMCandida Plus has recently been marketed as capable of presumptively identifying C. auris. The objective of this work was to analyze the ability of this new chromogenic medium to differentiate C. auris from other members of the C. haemulonii complex and from other yeasts commonly isolated in clinical practice. A collection of 220 strains including species of the C. haemulonii (n = 83) and C. parapsilosis (n = 80) complexes was studied. The strains were identified by molecular methods and cultured as individual or as mixed aqueous inoculum on CHROMagarTMCandida Plus plates. Colony morphotypes were evaluated at 5 time points. CHROMagarTMCandida Plus was a helpful tool for presumptive identification for C. auris. Better reading results were obtained after 48 hours of incubation at 35°C. It is able to easily differentiate C. auris from other closely related species of the C. haemulonii complex and other yeasts. This chromogenic medium would be also useful as screening and surveillance tool for C. auris colonization. However, we demonstrated that it would be a possible misidentification of C. parapsilosis as C. auris (44.3% showed similar morphotypes). To reduce false positives when it is used in a context of a C. auris outbreak, we propose to supplement the chromogenic medium with 8 μg/ml fluconazole. This modified medium was tested and it clearly differentiate C. parapsilosis from C. auris.
Insights
The CHROMagar Candida Plus medium aids in the presumptive identification of Candida auris, a significant public health concern. Supplementing this medium with fluconazole improves differentiation from Candida parapsilosis, reducing false positives during outbreaks.
Area of Science:
- Clinical Microbiology
- Infectious Diseases
- Medical Mycology
Background:
- Candida auris is an emerging multidrug-resistant yeast causing nosocomial infections.
- Accurate and rapid identification of C. auris is crucial for infection control.
- Chromogenic media offer a promising approach for presumptive yeast identification.
Purpose of the Study:
- To evaluate the efficacy of CHROMagar Candida Plus for presumptive identification of Candida auris.
- To assess its ability to differentiate C. auris from closely related species like the C. haemulonii complex and C. parapsilosis.
- To propose modifications for improving accuracy in C. auris screening.
Main Methods:
- A collection of 220 yeast strains, including C. haemulonii and C. parapsilosis complexes, were identified using molecular methods.
- Strains were cultured on CHROMagar Candida Plus, and colony morphotypes were assessed at various time points.
- A modified medium supplemented with fluconazole was tested for improved differentiation.
Main Results:
- CHROMagar Candida Plus showed utility for presumptive C. auris identification, with optimal results after 48 hours incubation at 35°C.
- The medium effectively differentiated C. auris from C. haemulonii complex species and other yeasts.
- A significant misidentification rate of C. parapsilosis as C. auris (44.3%) was observed.
- Supplementation with 8 μg/ml fluconazole clearly differentiated C. parapsilosis from C. auris.
Conclusions:
- CHROMagar Candida Plus is a valuable tool for the presumptive identification and surveillance of C. auris colonization.
- The medium aids in differentiating C. auris from closely related species.
- Supplementation with fluconazole is recommended to reduce false positives, particularly during C. auris outbreaks.
