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![Comparative recovery of Candida auris and other yeast species from mixtures on CHROMagar TM Candida Plus agar and Sabouraud dextrose agar with chloramphenicol. Mixtures of Candida auris plus Saccharomyces cerevisiae (Panels A and B), Candida auris plus Candida haemulonii (Panel C), Candida auris plus Trichosporon inkin (Panel D), or Candida auris plus Candida parapsilosis (Panel E), were prepared in saline as described in Materials and Methods and plated using sterile swabs onto CHROMagar Candida plus agar (left-hand side of each panel) and SABC agar (right-hand side of each panel). Plates were incubated at 35°C for 36 h (Panels A, plus C [left-hand side] and E [left-hand side]), or 60 h (Panels B, and D plus C [right-hand side] and E [right-hand side]).](profile/Andrew-Borman/publication/342131172/figure/fig2/AS:901621466808321@1591974717132/Comparative-recovery-of-Candida-auris-and-other-yeast-species-from-mixtures-on-CHROMagar.jpg)
Comparative recovery of Candida auris and other yeast species from mixtures on CHROMagar TM Candida Plus agar and Sabouraud dextrose agar with chloramphenicol. Mixtures of Candida auris plus Saccharomyces cerevisiae (Panels A and B), Candida auris plus Candida haemulonii (Panel C), Candida auris plus Trichosporon inkin (Panel D), or Candida auris plus Candida parapsilosis (Panel E), were prepared in saline as described in Materials and Methods and plated using sterile swabs onto CHROMagar Candida plus agar (left-hand side of each panel) and SABC agar (right-hand side of each panel). Plates were incubated at 35°C for 36 h (Panels A, plus C [left-hand side] and E [left-hand side]), or 60 h (Panels B, and D plus C [right-hand side] and E [right-hand side]).
Source publication
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Candida auris is a serious nosocomial health risk, with widespread outbreaks in hospitals worldwide. Successful management of such outbreaks has depended upon intensive screening of patients to identify those that are colonized and the subsequent isolation or cohorting of affected patients to prevent onward transmission. Here we describe the eva...
Contexts in source publication
Context 1
... mixed with S. cerevisiae, C. haemulonii, C. parapsilosis or T. inkin, were prepared in sterile saline. To mimic the swabbing approached used to screen potentially colonized patients, sterile swabs were dipped once in the different suspensions and then used to inoculate CHROMagar TM Candida Plus plates and SABC plates in parallel (Table 1 and Fig. 2), and all inoculated plates were incubated at 35°C. Cultures were evaluated after 36 h (the incubation time specified by the manufacturer) and again after 60 h. When suspensions of pure Candida auris were tested, significant numbers of distinctive colonies with blue haloes could be detected on CHROMagar TM Candida Plus as early as 36 h ...
Context 2
... similar results were obtained using mixed suspensions containing C. auris and a second unrelated yeast species (Table 1; Fig. 2). After 36 h incubation, significant numbers of distinctive C. auris colonies (blue halo) and S. cerevisiae Table 1. Comparison of CHROMagar TM Candida Plus medium and SABC agar for the recovery of Candida auris and other yeast ...
Context 3
... (mauve) were visible on CHROMagar TM Candida Plus plates ( Fig. 2A, left-hand panel), but only a small number of colonies (all corresponding to S. cerevisiae) were present on the equivalent SABC plates (Fig. 2A, right-hand panel). After incubation of these same plates for a total of 60 h (Fig. 2B), a number of smaller colonies (all corresponding to C. auris) were detected on the SABC plates in addition to the much ...
Context 4
... (mauve) were visible on CHROMagar TM Candida Plus plates ( Fig. 2A, left-hand panel), but only a small number of colonies (all corresponding to S. cerevisiae) were present on the equivalent SABC plates (Fig. 2A, right-hand panel). After incubation of these same plates for a total of 60 h (Fig. 2B), a number of smaller colonies (all corresponding to C. auris) were detected on the SABC plates in addition to the much larger S. cerevisiae colonies. However, recovery of both organisms was significantly greater CHROMagar TM Candida Plus plates than SABC medium (as ...
Context 5
... (mauve) were visible on CHROMagar TM Candida Plus plates ( Fig. 2A, left-hand panel), but only a small number of colonies (all corresponding to S. cerevisiae) were present on the equivalent SABC plates (Fig. 2A, right-hand panel). After incubation of these same plates for a total of 60 h (Fig. 2B), a number of smaller colonies (all corresponding to C. auris) were detected on the SABC plates in addition to the much larger S. cerevisiae colonies. However, recovery of both organisms was significantly greater CHROMagar TM Candida Plus plates than SABC medium (as judged by total cfu; Table 1). Panels C, D, and E of Figure 2 depict ...
Context 6
... recovery of both organisms was significantly greater CHROMagar TM Candida Plus plates than SABC medium (as judged by total cfu; Table 1). Panels C, D, and E of Figure 2 depict the results of the equivalent experiments performed with mixtures of C. auris with C. haemulonii, T. inkin, and C. parapsilosis, respectively. In all cases, C. auris colonies appeared significantly earlier, and in greater numbers, on CHROMagar TM Candida Plus plates as compared to SABC medium (Fig. 2, Table 1). ...
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Citations
... Culture-based screening of patient axilla and inguinal swabs involves manual interpretation of media which select for and differentiate Candida spp. after 18-36 h of incubation (6)(7)(8). While reliable, this form of screening can create a large burden for clinical laboratories when screening all inpatient admissions. ...
Candida auris is a multidrug-resistant opportunistic fungal pathogen capable of causing serious infections and healthcare-associated outbreaks. Screening for colonization with C. auris has become routine and is recommended in many hospitals and healthcare facilities as an infection control and prevention strategy. Subsequently, and since there are currently no FDA-approved tests for this purpose, clinical microbiology laboratories have become responsible for developing protocols to detect C. auris using axial and inguinal screening swabs. In a College of American Pathologists-accredited large academic healthcare center setting, we implemented a laboratory-developed nucleic-acid amplification test for the detection of C. auris DNA. Our test validation evaluated the performance of the DiaSorin C. auris primer set used in a real-time qualitative PCR assay on the LIAISON MDX thermocycler with the Simplexa Universal Disc. The assay was highly sensitive and specific, with a limit of detection of 1–2 CFU/reaction, with no observed cross-reactivity with other Candida spp., bacterial skin commensal organisms or commonly encountered viruses. When run in parallel with a culture-based detection method, the PCR assay was 100% sensitive and specific. The assay was precise, with low variability between replicates within and between runs. Lastly, pre-analytical factors, including swab storage time, temperature, and transport media, were assessed and found to have no significant effect on the detection of C. auris at variable concentrations. Taken together, this study expands the available options for nucleic acid detection of C. auris and characterizes pre-analytical factors for implementation in both high- and low-volume laboratory settings.
IMPORTANCE
This study overviews the validation and implementation of a molecular screening tool for the detection of Candida auris in a College of American Pathologist-accredited clinical laboratory. This molecular laboratory-developed test is both highly sensitive and specific and has significant health-system cost-savings associated with significantly reduced turn-around-time compared to traditional standard-of-care culture-based work up. This method and workflow is of interest to support clinical microbiology diagnostics and to help aid in hospital inpatient, and infection prevention control screening.
... Borman et al. showed that this medium promotes the rapid growth of C. auris with a distinctive color of the colonies (light blue with a blue halo) (Figure 3) (17). More recently, the specificity of this medium has been discussed, suggesting that adding fluconazole at 32 mg/ml to the "conventional" CHROMagar Candida medium could offer the best performances for C. auris identification (18). ...
Tinea capitis (TC) is still a frequent dermatophytosis in France, both autochthonous and imported. A nationwide retrospective survey was performed and a total of 4,395 TC cases were recorded within 36 French mycology laboratories during a 6-year period. TC is a disease that occurs in childhood with 85% of the cases occurring before 10 years old and 94% before the age of 15. Anthropophilic origin was predominant with 779 cases of Trichophyton tonsurans (32.6%), 738 cases of Trichophyton soudanense/T. violaceum (31%), and 445 cases of Microsporum audouinii (19.2%). Of note, T. tonsurans represents more than 80% of the cases in the French West Indies (Martinique and Guadeloupe). By contrast, zoophilic species were less prevalent with mainly M. canis (10.3%) confirming the shift from zoophilic to anthropophilic species observed in many centers during the last decades. During this survey, diagnosis methods were also collected. Most labs had a classical process for the diagnosis: microscopic direct examination associated to cultures on Sabouraud and Sabouraud-cycloheximide media (incubated between 25±5°C for 2 to 3 weeks) in all laboratories. Identification of the causal dermatophyte was performed by microscopic and macroscopic examination of the cultures in 100% of the labs, with various specific culture media available when fructification was insufficient (mainly malt or potato-dextrose agar, or Borelli medium). New techniques were also implemented with the introduction of MALDI-TOF mass spectrometry identification in more than two third of the labs, and molecular identification available if necessary in half of the labs.
... However, previously available formulations cannot visually distinguish C. auris from other Candida species. CHROMagar (France) has recently developed a novel chromogenic media designed to permit visual identification of C. auris, which appears as a light blue colony with a blue halo on this media (6)(7)(8). In this study, we evaluated this media according to manufacturer's instructions with a panel of 206 fungal isolates that included 68 C. auris isolates. ...
CHROMagar Candida Plus is a new formulation of chromogenic media designed for the detection and differentiation of major clinical Candida species, including Candida auris . The objective of this study is to evaluate CHROMagar Candida Plus when used according to manufacturer’s instructions with a panel of 206 fungal isolates and 83 skin-swab specimens originally collected for C. auris colonization screening. Of the 68 C . auris isolates tested, 66/68 displayed the expected light-blue colony morphology and blue halo within 48 h. None of the remaining 138 non- auris isolates appeared similar to C. auris . CHROMagar Candida Plus was, therefore, inclusive to 97% of 68 C . auris isolates tested and supported visual exclusion of 100% of the 138 non- C . auris isolates tested. For the 83 colonization screening specimens, direct plating onto CHROMagar Candida Plus was 60% sensitive and 100% specific when compared to the enrichment broth gold-standard reference method. In sum, these findings demonstrate the utility of this media when working with isolates but also notable limitations when working with primary skin-swabs specimens when competing yeast species are present.
IMPORTANCE
Candida auris is an emerging fungal pathogen of public health concern. As it continues to spread, it is important to publish evaluations of new diagnostic tools. In this study, we share our experience with a new chromogenic media which can help distinguish C. auris from related species.
... The undetected spread of C. auris is thought to be due to misidentification using conventional phenotypic methods, as it is fairly similar to other Candida species (2,11,12). However, major advances have been made in identifying C. auris using selective media and molecular diagnostic tools (11,(13)(14)(15)(16)(17). The greatest threat that C. auris poses is that it has shown to be resistant to important life-saving antifungal therapies in healthcare, such as fluconazole, amphotericin B, and echinocandins (4,18,19). ...
Candida auris has emerged as a global healthcare threat, displaying resistance to important healthcare antifungal therapies. Infection prevention and control protocols have become paramount in reducing transmission of C. auris in healthcare, of which cleaning and disinfection plays an important role. Candida albicans is used as a surrogate yeast for yeasticidal claims of disinfection products, but reports have been made that sensitivity to disinfectants by C. auris differs from its surrogate. In this review, we aimed to compile the information reported for products used for skin and hard surface disinfection against C. auris in its planktonic or biofilm form. A comparison was made with other Candida species, and information were gathered from laboratory studies and observations made in healthcare settings.
... Whereas some guidelines recommend 10-day culture incubation for primary specimens (17), our verification showed that direct specimen cultures may be reliably called "C. auris positive" after incubation for five days since 95% of cultures produce pigmentation characteristic of C. auris by 4.26 days, where a positive colony is one possessing a pink colour with diffusible blue pigmentation in the surrounding agar. Some Candida species such as C. vulturna, C. pseudohaemulonii, and C. parapsilosis can cause false positives on this media (18)(19)(20). While our verification panel did not include C. vulturna and C. pseudohaemulonii, our C. parapsilosis isolates were reliably and distinctly identified. ...
In this verification study, we compare and contrast the performance characteristics of chromogenic agar culture, direct PCR, and broth enrichment followed by either culture or PCR, for the detection of C. auris colonization. We find that culture and PCR both offer excellent performance, with broth enrichment offering little performance advantage given its cost.
... From 2017, there were three studies have demonstrated the Polymerase Chain Reaction (PCR) based method enable to identify the C. auris and phylogenetic relatives (Kordalewska et al., 2017;Arastehfar et al., 2018Arastehfar et al., , 2019. Beside the aforementioned molecular method, Elizabeth M Johnson has established a novel and expeditious method for identifying the C. auris isolates from patient samples, which was named as the CHROMagarTM Candida Plus (Borman et al., 2021). Besides above mentioned methods, the MALDI-TOF MS and ITS sequencing can only be used to identify C. auris species but cannot distinguish between the five clades. ...
Introduction
Candida auris , a fungal pathogen first reported in 2009, has shown strong resistance to azole antifungal drugs and has caused severe nosocomial outbreaks. It can also form biofilms, which can colonize patients’ skin and transmit to others. Despite numerous reports of C. auris isolation in various countries, many studies have reported contradictory results.
Method
A bibliometric analysis was conducted using VOSviewer to summarize research trends and provide guidance for future research on controlling C. auris infection. The analysis revealed that the United States and the US CDC were the most influential countries and research institutions, respectively. For the researchers, Jacques F. Meis published the highest amount of related articles, and Anastasia P. Litvintseva’s articles with the highest average citation rate. The most cited publications focused on clade classification, accurate identification technologies, nosocomial outbreaks, drug resistance, and biofilm formation. Keyword co-occurrence analysis revealed that the top five highest frequencies were for ‘drug resistance,’ ‘antifungal susceptibility test,’ ‘infection,’ ‘ Candida auris, ’ and ‘identification.’ The high-frequency keywords clustered into four groups: rapid and precise identification, drug resistance research, pathogenicity, and nosocomial transmission epidemiology studies. These clusters represent different study fields and current research hotspots of C. auris .
Conclusion
The bibliometric analysis identified the most influential country, research institution, and researcher, indicating current research trends and hotspots for controlling C. auris.
... CHROMagar™ Candida, a selective chromogenic culture medium for the direct qualitative detection and identification of Candida spp. based on the color of colonies, was used in this study [27]. As shown in Fig. 1, each fungal colony was presented with a specific color, revealing its type. ...
In the nature, Candida species are normal inhabitants and can be observed in a wide variety of vertebrates. In humans, especially for cancer patients who fall prey to opportunistic pathogens, this group of susceptible multi-drug resistant and biofilm-forming yeasts, are among the commonest ones. In this study, Candida species in 76 oral lesion samples from Vietnamese nasopharyngeal-cancer patients were isolated, morphologically identified using CHROMagar™, germ tube formation, and chlamydospore formation tests, and molecularly confirmed by PCR-RFLP. The drug susceptibility of these isolates was then tested, and the gene ERG11 was DNA sequenced to investigate the mechanism of resistance.
The results showed that Candida albicans remained the most prevalent species (63.16% of the cases), followed by Candida glabrata, Candida tropicalis, and Candida krusei. The rates of resistance of non-albicans Candida for tested drugs were 85.71%, 53.57%, and 57.14% to fluconazole, clotrimazole, and miconazole, respectively. Although the drug-resistance rate of Candida albicans was lower than that of non-albicans Candida, it was higher than expected, suggesting an emerging drug-resistance phenomenon. Furthermore, ERG11 DNA sequencing revealed different mutations (especially K128T), implying the presence of multiple resistance mechanisms. Altogether, the results indicate an alarming drug-resistance situation in Candida species in Vietnamese cancer patients and emphasize the importance of species identification and their drug susceptibility prior to treatment.
... All Fungal isolates were identified with CHROM agar TM Candida Media to confirm the presence of the five Candida species (C. albicans, C. tropicalis, C. krusei, C. glabrta and C. auris) [33]. Furthermore, all uropathogen isolates were identified phenotypically using standard clinical laboratory methods [32]. ...
Background
Asymptomatic urinary tract infection (asymptomatic bacteriuria and asymptomatic candiduria) may not be routinely detected in sexually active non-pregnant female population at the initial and reversible stages. This is mainly due to the fact that most women may not feel compelled to seek medical attention.
Objectives
The aim of this study was to determine the prevalence, and factors associated with urinary tract infection (UTI), and antibiogram of the uropathogen isolates among asymptomatic female college students.
Methods
An institutional-based cross-sectional study was conducted at selected colleges in Dessie from January 2021–March 2021. A total of 422 reproductive age (15 to 49 years) non-pregnant female students were included. Socio-demographic and clinical characteristics data were collected using structured questionnaires. Ten mLs of freshly voided mid-stream urine specimen was collected, transported and processed according to the standard operating procedures. Data were coded and entered for statistical analysis using SPSS version 22.0. Descriptive statistics, bivariate and multivariate logistic regression analysis were performed and p-values <0.05 with the corresponding 95% confidence interval (CI) were considered statistically significant.
Result
The overall prevalence of UTI was 24.6%. The prevalence of asymptomatic UTI bacteriuria and candiduria was 57 (13.5%) and 47 (11.1%), respectively. The predominant uropathogens were Staphylococcus saprophyticus 24 (23.1%), followed by Candida tropicalis 23 (22.1%), Candida albican 10 (9.6%), Candida krusei 9 (8.7%) and Escherichia coli 8 (7.7%). Gram negative bacterial isolates showed a higher level of resistance to amoxicillin-clavulanic acid 24 (92.3%). Gram positive bacterial uropathogens showed high level of resistance to penicillin 28 (96.6%) and trimethoprim-sulfamethoxazole 23 (79.3%). Gram positive bacterial isolates were sensitive to norfloxacin, clindamycin, and ciprofloxacin, accounting for 24 (82.7%), 20 (69.0%), and 19 (65.5%), respectively. Multidrug resistance was seen in 50 (87.7%) of bacterial uropathogens. Factors identified for acquisition of UTI were frequency of sexual intercourse (≥3 per week) (AOR = 7.91, 95% CI: (2.92, 21.42), and genital area washing habit (during defecation (AOR = 5.91, 95%CI: (1.86, 18.81) and every morning (AOR = 6.13, 95%CI: (1.60, 23.45)).
Conclusion
A significant prevalence of uropathogens, and high resistance of bacterial isolates to the commonly prescribed drugs were detected. Therefore, routine UTI screening, regular health education on the risk of asymptomatic infectious diseases for reproductive age group females, and antimicrobial susceptibility testing should be practiced to avoid the progression of an asymptomatic infection into a symptomatic UTI.
... C. auris appears pale cream, with a distinctive blue halo after 36 h growth at 35°C. All other Candida species, except for C. diddensiae, show distinct colors, and frequently C. parapsilosis exhibits a morphotype similar to that of C. auris, yielding false-positive results (16,102). ...
Candida auris is a multidrug-resistant fungal pathogen that presents a serious threat to global human health. Since the first reported case in 2009 in Japan, C. auris infections have been reported in more than 40 countries, with mortality rates between 30% and 60%. In addition, C. auris has the potential to cause outbreaks in health care settings, especially in nursing homes for elderly patients, owing to its efficient transmission via skin-to-skin contact. Most importantly, C. auris is the first fungal pathogen to show pronounced and sometimes untreatable clinical drug resistance to all known antifungal classes, including azoles, amphotericin B, and echinocandins. In this review, we explore the causes of the rapid spread of C. auris. We also highlight its genome organization and drug resistance mechanisms and propose future research directions that should be undertaken to curb the spread of this multidrug-resistant pathogen.
Expected final online publication date for the Annual Review of Microbiology, Volume 77 is September 2023. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
... The utilization of two primer pairs for the GPI protein in a single PCR provides an enhanced robustness to the PCR assay, and helps to avoid potential false negatives due to recent evolutionary events, as observed in two isolates. The PCR approach, which depends on the singularity of chosen genes encoding the GPI protein, is a viable and cost-effective means of accurately identifying C. auris infections in clinical settings [25]. ...
