Work

Candidozyma auris: Identification, antifungal susceptibility, and caspofungin-induced paradoxical growth

Year: 2026

Type: article

Abstract: PURPOSE: The aim of this study is to evaluate the effectiveness of VITEK®2 and CHROMagar™ Candida Plus agar in the identification of C. auris, using MALDI-TOF MS results as the reference standard. Additionally, to assess antifungal susceptibility, the study compares the results of two widely used commercial methods in routine laboratory practice: VITEK®2 and Sensititre™ YeastOne™ (SYO). METHODS: A total of 63 C. auris isolates were included in the study. VITEK®2 results were evaluated in comparison to SYO, and categorical agreement, major error (ME), and very major error (VME) rates were calculated. MIC50, MIC90 values and resistance rates determined by both methods were compared. The Eagle effect was also investigated. RESULTS: The VITEK®2 results (74 %) and the morphological characteristics of colonies grown on CHROMagar™ Candida Plus (100 %) were found to be consistent with MALDI-TOF MS identification. In the SYO method, the MIC values for amphotericin B, fluconazole, and voriconazole were found to be higher compared to those obtained by VITEK®2. No resistance was detected against micafungin and anidulafungin. Resistance observed in relation to caspofungin MIC values was identified as the Eagle effect. MIC50 and MIC90 values determined by VITEK®2 were lower than those obtained by SYO, except for amphotericin B, for which VITEK®2 showed a higher MIC90 value. CONCLUSION: In our study, it was observed that CHROMagar™ Candida Plus can be used as a screening method for the identification of C. auris in hospitals without access to MALDI-TOF MS. Incompatibility was detected in antifungal susceptibility testing, and the rates of major error (ME) and very major error (VME) were found to be high. For caspofungin, the high dilution range in the SYO method was determined which also detected the Eagle effect.

Source: Indian Journal of Medical Microbiology

DOI: 10.1016/j.ijmmb.2026.101065

Authors: Gülşah Ece Özmerdiven, Arzu İrvem

Institution: İstanbul Kanuni Sultan Süleyman Eğitim ve Araştırma Hastanesi

Language: English

Topic: Antifungal resistance and susceptibility

Subfield: Infectious Diseases

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,210