A high-throughput and rapid method for accurate identification of emerging multidrug-resistant Candida auris

Mycoses. 2019 Jun;62(6):513-518. doi: 10.1111/myc.12907. Epub 2019 Apr 4.

Abstract

Candida auris is an emerging multidrug-resistant yeast associated with invasive infection in healthcare settings. Recently, C auris cases in the United States have been detected in 11 states with the majority of cases in New York, New Jersey and Illinois. Rapid and accurate identification of C auris is critical for patient care and the implementation of public health measures to control the spread of infection. Our aim was to develop and validate a rapid DNA extraction method using the Roche MagNA Pure 96 instrument and a TaqMan real-time PCR assay for reliable, high-throughput identification of C auris. We evaluated 247 patient dermal swab samples previously analysed by culture/MALDI-TOF. The diagnostic sensitivity and specificity were 93.6% and 97.2%, respectively. The assay was highly reproducible with a detection limit of 1 C auris CFU/10 μL. A receiver operating characteristic curve analysis of the real-time PCR data showed an area of 0.982 under the curve, with a CT cut-off value of ≤37.0. The turnaround time from DNA extraction to real-time PCR results was approximately 200 samples/day. In conclusion, we successfully validated a rapid and high-throughput method for accurate and reproducible identification of C auris with a significantly reduced turnaround time compared to culture/MALDI-TOF based methods.

Keywords: Candida auris; TaqMan real-time PCR; high-throughput rapid DNA extraction.

Publication types

  • Evaluation Study

MeSH terms

  • Candida / genetics
  • Candida / isolation & purification*
  • Candidiasis, Invasive / diagnosis*
  • Candidiasis, Invasive / microbiology*
  • Communicable Diseases, Emerging / diagnosis
  • Communicable Diseases, Emerging / microbiology
  • DNA, Fungal / genetics
  • DNA, Fungal / isolation & purification*
  • Drug Resistance, Multiple, Fungal
  • Humans
  • Molecular Diagnostic Techniques / methods*
  • ROC Curve
  • Real-Time Polymerase Chain Reaction / methods*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Specimen Handling / methods*
  • Time Factors
  • United States

Substances

  • DNA, Fungal