Cited by 373Antifungal resistance and susceptibilityYeasts and Rust Fungi StudiesFungal Infections and Studies

Multidrug-resistant endemic clonal strain of Candida auris in India

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Chowdhary, A., Anil Kumar, V., Sharma, C., Prakash, A., Agarwal, K., Babu, R., Dinesh, K. R., Karim, S. +3 more·2014·European Journal of Clinical Microbiology & Infectious Diseases

Abstract

Candida auris is a recently described rare agent of fungemia. It is notable for its antifungal resistance. A total of 15 C. auris isolates, originating from seven cases of fungemia, three cases of diabetic gangrenous foot, and one case of bronchopneumonia from a tertiary care hospital in south India, were investigated. All of the 15 isolates were identified by sequencing and 14 of these along with 12 C. auris isolates previously reported from two hospitals in Delhi, north India, two each from Japan and Korea were genotyped by amplified fragment length polymorphism (AFLP). In vitro antifungal susceptibility testing (AFST) was done by the Clinical and Laboratory Standards Institute (CLSI) broth microdilution method. Candida auris isolates were misidentified as Candida haemulonii by VITEK. All were resistant to fluconazole [geometric mean minimum inhibitory concentration (MIC) 64 μg/ml] and 11 isolates were resistant to voriconazole (MIC ≥1 μg/ml). Forty-seven percent of the C. auris isolates were resistant to flucytosine (MIC ≥64 μg/ml) and 40% had high MIC (≥1 μg/ml) of caspofungin. Breakthrough fungemia developed in 28.6% of patients and therapeutic failure in 4 (66.7%) patients. Interestingly, the 26 Indian C. auris isolates from north and south India were clonal and phenotypically and genotypically distinct from Korean and Japanese isolates. The present study demonstrates that C. auris is a potential emerging pathogen that can cause a wide spectrum of human mycotic infections. The prevalence of a C. auris endemic clonal strain resistant to azoles and other antifungals in Indian hospitals with high rates of therapeutic failure in cases of fungemia is worrisome.

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Authors
Chowdhary, A., Anil Kumar, V., Sharma, C., Prakash, A., Agarwal, K., Babu, R., Dinesh, K. R., Karim, S., Singh, S. K., Hagen, F., & Meis, J. F.
Affiliations
  • University of Delhi (IN)
  • Amrita Institute of Medical Sciences and Research Centre (IN)
  • Canisius-Wilhelmina Ziekenhuis (NL)
  • Radboud University Medical Center (NL)
Corresponding author
Chowdhary, A.
Venue
European Journal of Clinical Microbiology & Infectious Diseases
Published
2013-12-20
Volume
33
Issue
6
Pages
919-926
ISSN
  • 0934-9723 (ISSN-L)
  • 1435-4373
OpenAlex
W1979435687
Cited by
373
References
17
Citations by year
2026: 13 · 2025: 15 · 2024: 23 · 2023: 32 · 2022: 34 · 2021: 40 · 2020: 46 · 2019: 50 · 2018: 40 · 2017: 52 · 2016: 17 · 2015: 7 · 2014: 4
FWCI
6.79
Type
journal article
Language
en
Open access
Locations
  • European Journal of Clinical Microbiology & Infectious Diseases (publishedVersion)
  • PubMed (publishedVersion)
  • Radboud Repository (Radboud University) (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Funders
  • University Grants Commission (F.2-15/2003SA-I)
  • Fonds National de la Recherche Luxembourg
  • Qatar National Research Fund (5-298-3-086, NPRP 5‐298‐3‐086)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Yeasts and Rust Fungi Studies
  • Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
Keywords
Candida auris, multidrug resistance, fungemia, clonal strains, endemic fungal infection, antifungal resistance, azole resistance, fluconazole resistance, voriconazole resistance, flucytosine resistance, caspofungin resistance, emerging fungal pathogens
MeSH terms
Adult, Aged, Aged, 80 and over, Antifungal Agents, Candida, Candidiasis, Child, Preschool, DNA, Fungal, Female, Genotype, Humans, India, Male, Microbial Sensitivity Tests, Middle Aged, Cluster Analysis, Mycological Typing Techniques, Treatment Failure, Endemic Diseases, Drug Resistance, Multiple, Fungal, Amplified Fragment Length Polymorphism Analysis, Young Adult, Molecular Typing, Tertiary Care Centers

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