New Clonal Strain of Candida auris, Delhi, India

Anuradha Chowdhary

, Cheshta Sharma, Shalini Duggal, Kshitij Agarwal, Anupam Prakash, Pradeep Kumar Singh, Sarika Jain, Shallu Kathuria, Harbans S. Randhawa, Ferry Hagen, and Jacques F. Meis

Author affiliations: Author affiliations: Vallabhbhai Patel Chest Institute, Delhi, India (A. Chowdhary, C. Sharma, K. Agarwal, A. Prakash, P.K. Singh, S. Kathuria, H.S. Randhawa); B.L. Kapur Memorial Hospital, New Delhi, India (S. Duggal, S. Jain); Canisius-Wilhelmina Hospital, Nijmegen, the Netherlands (F. Hagen, J.F. Meis); and Radboud University Nijmegen Medical Centre, Nijmegen (J.F. Meis)

Abstract

A new clonal strain of Candida auris is an emerging etiologic agent of fungemia in Delhi, India. In 12 patients in 2 hospitals, it was resistant to fluconazole and genotypically distinct from isolates from South Korea and Japan, as revealed by M13 and amplified fragment length polymorphism typing.

In 2009, yeast isolates from the external ear canal of a Japanese patient were identified as a new species, Candida auris, on the basis of sequence analysis of the nuclear rRNA gene. The species is phylogenetically related to C. haemulonii (1). In the same year, 15 isolates of C. auris were reported from otitis media patients in South Korea (2). Genotyping of these isolates revealed a clonal origin (3). In addition, in 3 patients, persistent fungemia caused by C. auris was resistant to fluconazole; 2 of these patients died (4). Fungemia caused by C. auris seems to be extremely rare, however. We report a series of fungemia cases caused by a new clonal strain of this emerging pathogen, involving 12 inpatients from 2 hospitals in Delhi, India.

The Study

We characterized 12 bloodstream C. auris isolates, originating from an equal number of patients, collected during 2009–2011 at 2 hospitals (a tertiary care general hospital and a pediatric center) in Delhi, India. The controls included reference strains of C. auris from South Korea (CBS 12372, CBS 12373) and Japan (JCM15448, DSMZ21092), C. haemulonii (CBS 7801–7802, CBS 5149, CBS 5150), C. pseudohaemulonii (KCTC 1787, CBS 10004, JCM 12453), and C. duobushaemulonii (CBS 7798–7800, CBS 9754).