Emergence of the novel sixth Candida auris Clade VI in Bangladesh

Emergence of the novel sixth Candida auris Clade VI in Bangladesh

July 2024 | Tahsin Khan, Naimul Islam Faysal, Md Mobarok Hossain, Syeda Mah-E-Muneer, Arefeen Haider, Shovan Basak Moon, Debashis Sen, Dilruba Ahmed, Lindsay A. Parnell, Mohammad Jubair, Nancy A. Chow, Fahmida Chowdhury, Mustafizur Rahman
A novel sixth clade (Clade VI) of Candida auris has emerged in Bangladesh, as revealed by whole-genome sequencing (WGS) of 10 isolates collected from hospital settings. These isolates were identified using CHROMagar Candida Plus and VITEK2 systems, followed by WGS using the Illumina NextSeq 550 platform. Phylogenetic analysis showed that 8 isolates clustered with Clade I, while 2 formed a distinct cluster with over 42,447 single-nucleotide polymorphism (SNP) differences compared to Clade IV. This indicates the emergence of Clade VI, which may have international transmission potential. Antifungal susceptibility testing (AFST) revealed that 80% of isolates were resistant to fluconazole and voriconazole, while Clade VI isolates were susceptible to azoles, echinocandins, and pyrimidine analogs. Genomic analysis identified ERG11_Y132F mutation conferring azole resistance and FCY1_S70R mutation, which was inconsequential for 5-flucytosine resistance. The study highlights the need for comprehensive genomic surveillance in Bangladesh to understand the emergence, transmission dynamics, and resistance profiles of C. auris infections. The discovery of Clade VI underscores the importance of advanced sequencing methodologies in tracking the spread of this multidrug-resistant pathogen. C. auris, first identified in 2009, has become a critical concern due to its antifungal resistance and high mortality rates in healthcare-associated outbreaks. WGS has proven to be the most accurate identification technique for C. auris, revealing five distinct clades. The emergence of Clade VI in Bangladesh suggests a new lineage with potential for global spread. The study also highlights the importance of genomic surveillance to monitor the circulation of C. auris clades and resistance patterns, which is crucial for preventing transmission and managing outbreaks. The findings emphasize the need for continued research and surveillance to better understand and combat the threat posed by C. auris.A novel sixth clade (Clade VI) of Candida auris has emerged in Bangladesh, as revealed by whole-genome sequencing (WGS) of 10 isolates collected from hospital settings. These isolates were identified using CHROMagar Candida Plus and VITEK2 systems, followed by WGS using the Illumina NextSeq 550 platform. Phylogenetic analysis showed that 8 isolates clustered with Clade I, while 2 formed a distinct cluster with over 42,447 single-nucleotide polymorphism (SNP) differences compared to Clade IV. This indicates the emergence of Clade VI, which may have international transmission potential. Antifungal susceptibility testing (AFST) revealed that 80% of isolates were resistant to fluconazole and voriconazole, while Clade VI isolates were susceptible to azoles, echinocandins, and pyrimidine analogs. Genomic analysis identified ERG11_Y132F mutation conferring azole resistance and FCY1_S70R mutation, which was inconsequential for 5-flucytosine resistance. The study highlights the need for comprehensive genomic surveillance in Bangladesh to understand the emergence, transmission dynamics, and resistance profiles of C. auris infections. The discovery of Clade VI underscores the importance of advanced sequencing methodologies in tracking the spread of this multidrug-resistant pathogen. C. auris, first identified in 2009, has become a critical concern due to its antifungal resistance and high mortality rates in healthcare-associated outbreaks. WGS has proven to be the most accurate identification technique for C. auris, revealing five distinct clades. The emergence of Clade VI in Bangladesh suggests a new lineage with potential for global spread. The study also highlights the importance of genomic surveillance to monitor the circulation of C. auris clades and resistance patterns, which is crucial for preventing transmission and managing outbreaks. The findings emphasize the need for continued research and surveillance to better understand and combat the threat posed by C. auris.
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[slides and audio] Emergence of the novel sixth Candida auris Clade VI in Bangladesh