Verification, Analytical Sensitivity, Cost-effectiveness, and Comparison of 4 Candida auris Screening Methods

Area of Science:

• Medical Mycology
• Infectious Diseases
• Diagnostic Microbiology

Background:

• *Candida auris* is an emerging multidrug-resistant yeast with significant public health implications.
• Accurate and rapid detection of *Candida auris* colonization is essential for infection control.
• Various diagnostic methods exist, each with unique performance characteristics.

Purpose of the Study:

• To compare the performance of chromogenic agar culture, direct polymerase chain reaction (PCR), and broth enrichment followed by culture or PCR for detecting *Candida auris* colonization.
• To evaluate the clinical utility and cost-effectiveness of different diagnostic approaches.

Main Methods:

• A verification study design was employed.
• Performance characteristics of chromogenic agar culture, direct PCR, and broth enrichment (followed by culture or PCR) were assessed.
• Detection of *Candida auris* colonization was the primary outcome measure.

Main Results:

• Both chromogenic agar culture and direct PCR demonstrated excellent performance for *Candida auris* detection.
• Broth enrichment, when used as a preliminary step, offered little additional performance advantage.
• The cost-effectiveness of broth enrichment was deemed unfavorable compared to direct methods.

Conclusions:

• Chromogenic agar culture and direct PCR are highly effective methods for detecting *Candida auris* colonization.
• Broth enrichment is not recommended as a routine method due to limited performance benefits and added cost.
• Optimized diagnostic strategies should prioritize direct culture or PCR for efficient *Candida auris* surveillance.