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A 96 Well Microtiter Plate-based Method for Monitoring Formation and Antifungal Susceptibility Testing of Candida albicans Biofilms
Published on: October 21, 2010
A simple and sensitive test for Candida auris colonization, surveillance, and infection control suitable for near
Sukalyani Banik1, Burcu Ozay2, Marisol Trejo3
1Center for Emerging Pathogens, Department of Medicine, Public Health Research Institute, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
Abstract:
Candida auris is a multidrug-resistant fungal pathogen with a propensity to colonize humans and persist on environmental surfaces. C. auris invasive fungal disease is being increasingly identified in acute and long-term care settings. We have developed a prototype cartridge-based C. auris surveillance assay (CaurisSurV cartridge; "research use only") that includes integrated sample processing and nucleic acid amplification to detect C. auris from surveillance skin swabs in the GeneXpert instrument and is designed for point-of-care use. The assay limit of detection (LoD) in the skin swab matrix was 10.5 and 14.8 CFU/mL for non-aggregative (AR0388) and aggregative (AR0382) strains of C. auris, respectively. All five known clades of C. auris were detected at 2-3-5× (31.5-52.5 CFU/mL) the LoD. The assay was validated using a total of 85 clinical swab samples banked at two different institutions (University of California Los Angeles, CA and Wadsworth Center, NY). Compared to culture, sensitivity was 96.8% (30/31) and 100% (10/10) in the UCLA and Wadsworth cohorts, respectively, providing a combined sensitivity of 97.5% (40/41), and compared to PCR, the combined sensitivity was 92% (46/50). Specificity was 100% with both clinical (C. auris negative matrix, N = 31) and analytical (non-C. auris strains, N = 32) samples. An additional blinded study with N = 60 samples from Wadsworth Center, NY yielded 97% (29/30) sensitivity and 100% (28/28) specificity. We have developed a completely integrated, sensitive, specific, and 58-min prototype test, which can be used for routine surveillance of C. auris and might help prevent colonization and outbreaks in acute and chronic healthcare settings.
Importance:
This study has the potential to offer a better solution to healthcare providers at hospitals and long-term care facilities in their ongoing efforts for effective and timely control of Candida auris infection and hence quicker response for any potential future outbreaks.
Insights
A new rapid assay for Candida auris surveillance has been developed. This sensitive and specific test can detect the multidrug-resistant fungus from skin swabs in under an hour, aiding in healthcare outbreak prevention.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Diagnostic Assay Development
Background:
- Candida auris is a multidrug-resistant yeast causing invasive infections in healthcare settings.
- C. auris colonizes patients and persists on surfaces, complicating infection control.
- Current surveillance methods may lack the speed and integration needed for timely intervention.
Purpose of the Study:
- To develop and validate a rapid, point-of-care surveillance assay for Candida auris.
- To enable timely detection and control of C. auris in healthcare environments.
- To provide a tool for preventing colonization and outbreaks.
Main Methods:
- Development of a prototype cartridge-based assay (CaurisSurV) for C. auris detection.
- Integrated sample processing and nucleic acid amplification on the GeneXpert instrument.
- Validation using clinical skin swab samples from two institutions and analytical testing with non-C. auris strains.
Main Results:
- The assay demonstrated limits of detection as low as 10.5 CFU/mL for C. auris.
- High combined sensitivity (97.5% vs. culture, 92% vs. PCR) and 100% specificity were achieved.
- The complete assay provides results in 58 minutes, detecting all five C. auris clades.
Conclusions:
- A sensitive, specific, and rapid prototype assay for C. auris surveillance has been successfully developed.
- The integrated, point-of-care assay can aid in routine surveillance and outbreak prevention in healthcare settings.
- This tool offers a potential solution for effective and timely control of C. auris infections.
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