AUTHOR=Reslan Lina , Araj George F. , Finianos Marc , El Asmar Rima , Hrabak Jaroslav , Dbaibo Ghassan , Bitar Ibrahim 

TITLE=Molecular Characterization of Candida auris Isolates at a Major Tertiary Care Center in Lebanon

JOURNAL=Frontiers in Microbiology

VOLUME=12

YEAR=2022

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2021.770635

DOI=10.3389/fmicb.2021.770635

ISSN=1664-302X

ABSTRACT=<sec><title>Background</title><p>The globally emerging <italic>Candida auris</italic> pathogens poses heavy burden to the healthcare system. Their molecular analyses assist in understanding their epidemiology, dissemination, treatment, and control. This study was warranted to describe the genomic features and drug resistance profiles using whole genome sequencing (WGS) among <italic>C</italic>. <italic>auris</italic> isolates from Lebanon.</p></sec><sec><title>Methods</title><p>A total of 28 <italic>C</italic>. <italic>auris</italic> clinical isolates, from different hospital units, were phenotypically identified by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) and tested for antifungal resistance using Vitek-2 system and E test. The complete genomes were determined by WGS using long reads sequencing (PacBio) to reveal the clade distribution and antifungal resistance genes.</p></sec><sec><title>Results</title><p><italic>Candida auris</italic> revealed uniform resistance to fluconazole and amphotericin B, with full susceptibility to echinocandins. Among key resistance genes studied, only two mutations were detected: Y132F in <italic>ERG11</italic> gene and a novel mutation, D709E, found in <italic>CDR1</italic> gene encoding for an ABC efflux pump. Phylogenetically, <italic>C</italic>. <italic>auris</italic> genomes belonged to South Asian clade I and showed limited genetic diversity, suggesting person to person transmission.</p></sec><sec><title>Conclusion</title><p>This characterization of <italic>C</italic>. <italic>auris</italic> isolates from Lebanon revealed the exclusivity of clade I lineage together with uniform resistance to fluconazole and amphotericin B. The control of such highly resistant pathogen necessitates an appropriate and rapid recovery and identification to contain spread and outbreaks.</p></sec>