First imported case of Candida auris infection in Milan, Italy: genomic characterisation

Infection. 2024 Aug;52(4):1633-1638. doi: 10.1007/s15010-024-02232-x. Epub 2024 Apr 1.

Abstract

Purpose: Candida auris, an emerging multidrug-resistant yeast, has been reported worldwide. In Italy, the first case was reported in 2019. We describe the first case of C. auris, imported from Greece, in Milan, using whole genome sequencing to characterise mutations associated with antifungal resistance.

Case presentation: On October 2022 an 80-year-old Italian man was hospitalised in Greece. In the absence of clinical improvement, the patient was transferred to our hospital, in Italy, where blood culture resulted positive for C. auris. Despite therapy, the patient died of septic shock. In a phylogenetic analysis the genome was assigned to Clade I with strains from Kenya, United Arab Emirates and India. D1/D2 region resulted identical to a Greek strain, as for many other strains from different World regions, highlighting the diffusion of this strain.

Conclusion: Importation of C. auris from abroad has been previously described. We report the first case of C. auris imported into Italy from Greece, according to phylogenetic analysis. This case reinforces the need for monitoring critically ill hospitalised patients also for fungi and addresses the need for the standardisation of susceptibility testing and strategies for diagnosis and therapy.

Keywords: Candida auris; Italy; Multi-Drug-Resistance-Organism; Whole-Genome-Sequencing; Yeast.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Antifungal Agents* / therapeutic use
  • Candida auris* / genetics
  • Candidiasis* / diagnosis
  • Candidiasis* / drug therapy
  • Candidiasis* / microbiology
  • Candidiasis, Invasive
  • Communicable Diseases, Imported / diagnosis
  • Communicable Diseases, Imported / microbiology
  • Fatal Outcome
  • Greece
  • Humans
  • Italy
  • Male
  • Microbial Sensitivity Tests
  • Phylogeny*
  • Whole Genome Sequencing

Substances

  • Antifungal Agents

Supplementary concepts

  • Candida auris infection