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Published on: December 28, 2017
Emergence and characterization of mixed Candida auris strain infections in China
Han Du1,2,3, Yanfeng Huang2, Penghao Guo4
1Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China.
Purpose:
The multidrug-resistant fungal pathogen Candida auris poses an increasing global health threat due to its high transmissibility and persistence in healthcare environments. We aimed to explore the potential cases of mixed C. auris-strain colonizations or infections in China and to investigate the genetic and biological diversity of the associated isolates.
Methods:
C. auris isolates from 5 colonization or infection cases were distinguished by colony morphology and verified by D1/D2-ITS alignment. Phylogenetic and genomic diversity analysis of all isolates were conducted using whole genome sequences. Comparative biological analysis of all isolates, including cellular and colony morphology, antifungal susceptibility, biofilm formation, SAP activity, and both in vitro and in vivo survival capabilities were performed.
Results:
Five cases of potential mixed C. auris-strain colonization or infections in China were identified. Comparative genomic analysis revealed these cases involved strains from two distinct genetic clades (I and III) or strains from the same clade but with genetic alterations. Comparative biological analysis demonstrated the strains from mixed colonization or infections exhibit differences in several key aspects, including colony morphology, biofilm formation, SAP activity, and both in vitro and in vivo survival capabilities.
Conclusion:
Comparative analyses revealed notable differences in biofilm formation, environmental survival, and secretion of virulence factors between the co-colonizing or co-infecting strains of C. auris. These biological and genetic disparities may present significant challenges for the diagnosis and treatment of C. auris infections, as strains with different genetic backgrounds may exhibit varying abilities to colonize host or environmental niches.
Insights
This study identified mixed Candida auris infections in China, revealing genetic and biological differences between strains. These variations impact biofilm formation and survival, complicating diagnosis and treatment of this global fungal threat.
Area of Science:
- Mycology
- Infectious Diseases
- Genomics
Background:
- Candida auris is a multidrug-resistant fungus causing global health concerns.
- Its high transmissibility and persistence in healthcare settings necessitate further research.
- Understanding strain diversity is crucial for effective control strategies.
Purpose of the Study:
- To investigate mixed Candida auris colonizations or infections in China.
- To analyze the genetic and biological diversity of C. auris isolates.
- To identify potential challenges in diagnosing and treating C. auris.
Main Methods:
- Isolates were identified using colony morphology and D1/D2-ITS alignment.
- Whole genome sequencing was employed for phylogenetic and genomic diversity analysis.
- Comparative biological analyses included morphology, antifungal susceptibility, biofilm formation, and survival capabilities.
Main Results:
- Five cases of mixed C. auris colonization or infection were identified in China.
- Isolates belonged to distinct genetic clades (I and III) or showed intra-clade alterations.
- Mixed strains exhibited significant differences in morphology, biofilm formation, and survival.
Conclusions:
- Co-colonizing or co-infecting C. auris strains display notable differences in virulence factors and survival.
- Genetic and biological disparities pose challenges for C. auris infection diagnosis and treatment.
- Varying colonization abilities of different strains complicate clinical management.
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