Candida auris in Intensive Care Setting: The First Case Reported in Portugal

Area of Science:

• Medical Mycology
• Infectious Diseases
• Genomics

Background:

• Candida auris is an emerging opportunistic fungal pathogen causing widespread nosocomial outbreaks globally.
• The World Health Organization identifies Candida auris as a critical priority pathogen due to its resistance patterns and public health threat.
• Nosocomial infections pose significant challenges in intensive care units (ICUs), especially in immunocompromised patients.

Purpose of the Study:

• To report the first case of Candida auris identified in Portugal.
• To characterize the antifungal susceptibility and genetic profile of the identified Candida auris isolate.
• To investigate the potential origin and implications of this case in a hospital setting.

Main Methods:

• Isolation and identification of Candida auris from bronchoalveolar lavage.
• Antifungal susceptibility testing (AFST) to determine resistance patterns.
• Whole-genome sequencing (WGS) for phylogenetic analysis and clade determination.

Main Results:

• The first case of Candida auris in Portugal was identified in a patient transferred from Angola.
• The isolate exhibited low susceptibility to azole antifungals.
• Phylogenetic analysis placed the isolate within genetic clade III, closely related to African strains.

Conclusions:

• This case highlights the potential for Candida auris importation and spread through patient transfer between countries.
• The azole resistance and clade III identification underscore the importance of vigilant monitoring for this pathogen.
• Continuous surveillance in healthcare settings is crucial to detect and manage Candida auris infections effectively.