Novel Chromogenic Medium CHROMagarTM Candida Plus for Detection of Candida auris and Other Candida Species from Surveillance and Environmental Samples: A Multicenter Study

Juan Vicente Mulet Bayona; Carme Salvador García; Nuria Tormo Palop; Amparo Valentín Martín; Carmelo González Padrón; Javier Colomina Rodríguez; Javier Pemán; Concepción Gimeno Cardona

doi:10.3390/jof8030281

Novel Chromogenic Medium CHROMagar^TM Candida Plus for Detection of Candida auris and Other Candida Species from Surveillance and Environmental Samples: A Multicenter Study

J Fungi (Basel). 2022 Mar 9;8(3):281. doi: 10.3390/jof8030281.

Authors

Juan Vicente Mulet Bayona¹, Carme Salvador García¹, Nuria Tormo Palop¹, Amparo Valentín Martín², Carmelo González Padrón³, Javier Colomina Rodríguez³, Javier Pemán², Concepción Gimeno Cardona^{1

4}

Affiliations

¹ Department of Microbiology and Parasitology, Consorcio Hospital General Universitario de Valencia, 46014 Valencia, Spain.
² Department of Microbiology and Parasitology, Hospital Universitari I Politècnic La Fe de Valencia, 46026 Valencia, Spain.
³ Department of Microbiology and Parasitology, Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain.
⁴ Department of Microbiology and Ecology, University of Valencia, 46010 Valencia, Spain.

Abstract

Epidemiological trends show a dramatic increase in the prevalence of fungal infections, and in the isolation of multidrug-resistant species, such as Candida auris. CHROMagar^TM Candida (CC; CHROMagar, Paris, France) and other chromogenic media, which are widely used in the clinical laboratory because they allow a rapid identification of most Candida species. Recently, CHROMagar^TM Candida Plus (CC-Plus; CHROMagar, Paris, France) was developed to detect and differentiate C. auris in addition to other major clinical Candida species, such as C. albicans, C. tropicalis, C. glabrata, or C. krusei. C. auris colonies display a differential light blue color with a blue halo. A multicentric study was designed to evaluate the performance of the CC-Plus medium in the detection of Candida species in patients' surveillance and environmental samples from three Spanish hospitals with active C. auris outbreaks. A total of 364 patients' surveillance samples and 212 environmental samples were tested. Samples were inoculated in CC and CC-Plus in parallel, and the plates were read at 24 and 48 h. All recovered colonies were presumptively identified according to colony color described by manufacturer, and the definitive identification was performed by mass spectrometry at 48 h. A total of 134 C. auris isolates were obtained (101 from patients' surveillance samples, and 33 from environmental samples). Sensitivity, specificity, and predictive positive and negative values were 99.5%, 100%, 100%, and 99.1%, respectively, for the main clinical Candida species, showing that CC-Plus is comparable to CC, with the advantage of being able to differentiate C. auris from C. parapsilosis. Furthermore, CC-Plus was able to detect one C. albicans, one C. glabrata, and eight C. auris that did not grow in CC. Additionally, the yeast colonies were generally larger, suggesting that this novel medium could be a richer medium, and suitable for surveillance and environmental cultures of C. auris and other clinically relevant Candida species.

Keywords: Candida auris; multi-drug resistant; surveillance; yeasts.

Grants and funding

APC/CHROMagar