{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T12:21:59Z","timestamp":1789474919814,"version":"build-2803163510"},"reference-count":56,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,11,3]],"date-time":"2019-11-03T00:00:00Z","timestamp":1572739200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p><jats:italic>Candida auris,<\/jats:italic> a multidrug\u2010resistant species, has the propensity of nosocomial transmission despite normal decontamination procedures. Here, we describe the isolation of <jats:italic>C\u00a0auris<\/jats:italic> from patients in various hospitals in Kuwait during 2014\u20102018. Susceptibility to antifungal drugs and molecular basis of resistance to fluconazole, voriconazole and micafungin were also studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p><jats:italic>Candida auris<\/jats:italic> (n\u00a0=\u00a0314) obtained from 126 patients in eight hospitals were studied. All isolates were identified by PCR amplification and\/or PCR\u2010sequencing of ribosomal DNA (rDNA). Antifungal susceptibility was determined by Etest. Molecular basis of resistance to fluconazole and micafungin was studied by PCR\u2010sequencing of <jats:italic>ERG11<\/jats:italic> and <jats:italic>FKS1<\/jats:italic> genes, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Bloodstream (n\u00a0=\u00a058), urine (n\u00a0=\u00a0124), respiratory (n\u00a0=\u00a098) and other (n\u00a0=\u00a034) specimens yielded 314 <jats:italic>C\u00a0auris<\/jats:italic> isolates. The proportion of bloodstream <jats:italic>C\u00a0auris<\/jats:italic> among all yeast isolates was higher (42 of 307, 13.7%) in 2018 as compared to 2014\u20102017 (16 of 964, 1.7%) (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.001). More bloodstream isolates (42 of 139) were cultured in 2018 than during 2014\u20102017 (16 of 175) (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.001). Resistance to amphotericin B, fluconazole, voriconazole and micafungin was detected in 27.1%, 100%, 41.1% and 1.7% isolates, respectively. Fluconazole\u2010resistant isolates contained either Y132F or K143R mutation in <jats:italic>ERG11<\/jats:italic>. Isolates with K143R mutation were additionally resistant to voriconazole. Micafungin\u2010resistant isolates contained S639F mutation in hot spot 1 of <jats:italic>FKS1<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our study highlights spreading of <jats:italic>C\u00a0auris<\/jats:italic> in major hospitals across Kuwait and its increasing role as a bloodstream pathogen in 2018. Cross\u2010resistance to voriconazole was also seen in isolates with K143R mutation in <jats:italic>ERG11,<\/jats:italic> while micafungin\u2010resistant isolates harboured S639F mutation in hot spot 1 of <jats:italic>FKS1<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13022","type":"journal-article","created":{"date-parts":[[2019,10,16]],"date-time":"2019-10-16T23:53:38Z","timestamp":1571270018000},"page":"104-112","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":80,"title":["<i>Candida auris<\/i> in various hospitals across Kuwait and their susceptibility and molecular basis of resistance to antifungal drugs"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3492-4781","authenticated-orcid":false,"given":"Suhail","family":"Ahmad","sequence":"first","affiliation":[{"name":"Department of Microbiology Faculty of Medicine Kuwait University Safat Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0555-0370","authenticated-orcid":false,"given":"Ziauddin","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Microbiology Faculty of Medicine Kuwait University Safat Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noura","family":"Al\u2010Sweih","sequence":"additional","affiliation":[{"name":"Department of Microbiology Faculty of Medicine Kuwait University Safat Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wadha","family":"Alfouzan","sequence":"additional","affiliation":[{"name":"Department of Microbiology Faculty of Medicine Kuwait University Safat Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leena","family":"Joseph","sequence":"additional","affiliation":[{"name":"Department of Microbiology Faculty of Medicine Kuwait University Safat Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,11,3]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1006290"},{"key":"e_1_2_10_3_1","first-page":"e00029","article-title":"Candida auris Incident management Team, Manuel R, Brown CS Candida auris: a Review of the Literature","volume":"31","author":"Jeffery\u2010Smith A","year":"2017","journal-title":"Clin Microbiol Rev"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmrp.2017.11.004"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1348-0421.2008.00083.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00319-11"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1086\/597108"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.06440-11"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.4103\/0255-0857.108746"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1910.130393"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-013-2027-1"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkx034"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.micpath.2018.09.014"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-018-1164-y"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw691"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-018-07779-6"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41426-018-0045-x"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2106.150270"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0195743"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2017.00247"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0142880"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmm.2004.01.002"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10482-008-9251-1"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10482-009-9406-8"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1439-0507.2008.01492.x"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00367-15"},{"key":"e_1_2_10_27_1","unstructured":"Center for Disease Control and Prevention. 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