Candida auris and Fungal Infection Diagnostics

The Threat of Candida auris

Candida auris is considered one of the most important fungal infections because it is often multi-drug resistant and it can be difficult to identify. A study published in August 2020 worked to uncover innate defense mechanisms against C. auris, with a hope to better understand how the fungus keeps its foothold in our bodies. Researchers were able to determine how our immune systems respond to C. auris versus other strains of Candida, such as Candida albicans. Collectively, the results of the study, “demonstrate that C. auris is a strong inducer of innate host defense, and identify possible targets for adjuvant immunotherapy.” Because fungal infections are frequently opportunistic, arising in patients with already compromised immune systems, there is strong interest in boosting patient immune response as a way of mitigating infection.

“We face Candida auris infections [worldwide] that are difficult to treat and to control,” said Dr. Alexandre Alanio, Mycologist MD Ph.D. from the Saint Louis Hospital in Paris, in an interview at ECCMID 2017 in Vienna. “Some [Candida auris] strains are resistant to many antifungal drugs – some up to three antifungal drugs. We did not see this with other Candida species.”

Be sure to watch bioMérieux’s interview with Dr. Alanio to learn more about C. auris:

To avoid inappropriate treatment and spread of infection, it is important to investigate further if there is any question about a Candida. “Be curious when you meet a Candida that you are not able to identify,” said Dr. Alanio.

Candida auris often goes unnoticed in routine microbiology laboratories, because some commercial identification systems often misidentify isolates C. haemulonii. Therefore, specialized laboratory methods are needed to accurately identify C. auris.

Opportunities and Challenges in Improving Fungal Infection Diagnosis

While microbial culture and microscopy techniques are considered the gold standard for diagnosing invasive fungal infections, there is a need for increased speed, sensitivity, and specificity. A recent review of detection and identification techniques, published in Frontiers in Microbiology, discusses the utility and challenges of direct detection in clinical specimens, genome-based identification and characterization, and molecular detection of antifungal drug resistance.

The review authors note that, “Pathology (or diagnostic) stewardship is an area deserving consideration when implementing new technologies, and appropriate use of diagnostic tests for IFD should directly complement antifungal stewardship.” Ultimately, considerations should be given to laboratory capacity for technology adoption, protocols for usage and interpretation methodologies should be established, and cost-benefit analysis should be performed. Done correctly, implementation of new technologies can both reduce costs and improve patient outcomes. The authors conclude that, “With high-level DNA barcoding, NGS technologies, and metagenomic approaches, the vision of a “one stop shop” for fungal biomarkers seems to be within reach in the foreseeable future.”

bioMérieux steps in to meet new identification needs.

New species of pathogens that can cause more severe infections and exhibit greater resistance to antimicrobials are a serious health concern globally. Fighting these pathogens requires concerted efforts on numerous levels. Microbiologists play a role in terms of providing rapid identification for clinicians to initiate and monitor appropriate treatment. bioMérieux is committed to keeping up with new threats by providing the diagnostic tools microbiologists need.

Check out the resources below to learn more about how bioMérieux constantly innovates to answer urgent identification needs.