First Report of <i>Candida auris</i> Isolated from a Patient with Severe Pneumonia in Zhejiang, China

Abstract

Introduction: Candida auris has emerged as a serious public health threat due to its multidrug resistance, remarkable transmissibility, and high mortality rates, resulting in global outbreaks. Here, we report the first detected case of C. auris in Zhejiang, China. Case Presentation: A 60-year-old male patient with severe pneumonia was previously treated in multiple hospitals in Nanjing before being transferred to the ICU at Jinhua Hospital of Zhejiang University. A yeast isolated from the patient's sputum cultures was identified as C. auris using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). The isolate underwent antifungal susceptibility testing, whole genome sequencing (WGS), and phylogenetic analysis. The isolate demonstrated high resistance to fluconazole while remaining susceptible to other antifungal agents and was classified under genetic clade I. Unfortunately, the patient's condition deteriorated, leading the family to decide against further treatment. Considering the patient’s clinical history and multiple hospital transfers, it is suspected that colonization or infection occurred in a previous hospital setting. Conclusions: Candida auris is an invasive fungal pathogen capable of causing severe infections. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry provides an accurate and timely method for detecting C. auris. Patients in intensive care units (ICUs), especially those with prolonged stays and multiple underlying conditions, are at heightened risk for acquiring C. auris infections. Admission screening and preventive control measures are crucial to preventing the spread of C. auris outbreaks.