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Multidrug-resistant endemic clonal strain of Candida auris in India
Open accessAbstract
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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“Indeed, nearly clonal isolates have emerged from hospitals in north and south India (77) and can spread through local transmission (78).”
From Transcriptomics and Phenotyping Define Genetic Signatures Associated with Echinocandin Resistance in Candida auris (2022) · cites this paper as [77]
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“C. auris is well known for its multi-drug resistant characteristics, with most isolates resistant to fluconazole, an important first-line antifungal agent (3, 6, 10, 11).”
From Clinical Efficacy and Safety of a Novel Antifungal, Fosmanogepix, in Patients with Candidemia Caused by Candida auris : Results from a Phase 2 Trial (2023) · cites this paper as [10]
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Metadata
- 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
- green
- hdl.handle.net
- Licence
- www.springer.com/tdm (tdm)
- 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 › Immunology and Microbiology › Microbiology › Yeasts and Rust Fungi Studies
- Health Sciences › Medicine › Infectious Diseases › 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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