Candidozyma auris Infection in Two Pediatric Patients in Turkey and Phylogenetic Analysis of the Isolates

Since its initial identification in 2009, Candidozyma auris demonstrates high virulence and multidrug resistance, posing a significant challenge to health management due to its association with nosocomial infections and difficulties in laboratory identification. While Candidozyma auris infections have been reported in Turkey since 2019, data regarding the pediatric population remain exceedingly rare. We present the first two pediatric cases of Candidozyma auris infection at our tertiary care center, with microbiological characteristics and phylogenetic features of the isolates. We documented two cases of a Candidozyma auris infection (urinary tract and bloodstream) in pediatric patients between August 2022 and September 2023. Microbiological features and antifungal susceptibility profiles of the isolates were analyzed. Phylogenetic analysis of the ITS1-5.8S-ITS2 rDNA region was conducted to confirm species-level identification and evaluate the phylogenetic relationship of the isolates with global reference sequences. The isolates were closely related to Clade I reference sequences and isolates were resistant to amphotericin B but susceptible to fluconazole and echinocandins. This is the first report presenting Candidozyma auris infections in pediatric patients with phylogenetic analysis and underscores the urgent need for heightened vigilance and strict infection control measures.