{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:54:15Z","timestamp":1791986055420,"version":"4.4.0"},"reference-count":29,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2015,6,1]],"date-time":"2015-06-01T00:00:00Z","timestamp":1433116800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2015,6]]},"abstract":"ABSTRACT<\/jats:title>\n \n Candida auris<\/jats:named-content>\n is a multidrug-resistant yeast that causes a wide spectrum of infections, especially in intensive care settings. We investigated\n C. auris<\/jats:named-content>\n prevalence among 102 clinical isolates previously identified as\n Candida haemulonii<\/jats:named-content>\n or\n Candida famata<\/jats:named-content>\n by the Vitek 2 system. Internal transcribed spacer region (ITS) sequencing confirmed 88.2% of the isolates as\n C. auris<\/jats:named-content>\n , and matrix-assisted laser desorption ionization\u2013time of flight mass spectrometry (MALDI-TOF MS) easily separated all related species,\n viz<\/jats:italic>\n .,\n C. auris<\/jats:named-content>\n (\n n<\/jats:italic>\n = 90),\n C. haemulonii<\/jats:named-content>\n (\n n<\/jats:italic>\n = 6),\n C. haemulonii<\/jats:named-content>\n var.\n vulnera<\/jats:named-content>\n (\n n<\/jats:italic>\n = 1), and\n Candida duobushaemulonii<\/jats:named-content>\n (\n n<\/jats:italic>\n = 5). The\n in vitro<\/jats:italic>\n antifungal susceptibility was determined using CLSI broth microdilution (CLSI-BMD), the Vitek 2 antifungal susceptibility test, and the Etest method.\n C. auris<\/jats:named-content>\n isolates revealed uniformly elevated fluconazole MICs (MIC\n 50<\/jats:sub>\n , 64 \u03bcg\/ml), and an alarming percentage of isolates (37%) exhibited elevated caspofungin MICs by CLSI-BMD. Notably, 34% of\n C. auris<\/jats:named-content>\n isolates had coexisting elevated MICs (\u22652 \u03bcg\/ml) for both fluconazole and voriconazole, and 10% of the isolates had elevated coexisting MICs (\u22652 \u03bcg\/ml) to two additional azoles, i.e., posaconazole and isavuconazole. In contrast to reduced amphotericin B MICs by CLSI-BMD (MIC\n 50<\/jats:sub>\n , 1 \u03bcg\/ml) for\n C. auris<\/jats:named-content>\n , elevated MICs were noted by Vitek 2 (MIC\n 50<\/jats:sub>\n , 8 \u03bcg\/ml), which were statistically significant.\n Candida auris<\/jats:named-content>\n remains an unnoticed pathogen in routine microbiology laboratories, as 90% of the isolates characterized by commercial identification systems are misidentified as\n C. haemulonii<\/jats:named-content>\n . MALDI-TOF MS proved to be a more robust diagnostic technique for rapid identification of\n C. auris<\/jats:named-content>\n . Considering that misleading elevated MICs of amphotericin B by the Vitek AST-YS07 card may lead to the selection of inappropriate therapy, a cautionary approach is recommended for laboratories relying on commercial systems for identification and antifungal susceptibility testing of rare yeasts.\n <\/jats:p>","DOI":"10.1128\/jcm.00367-15","type":"journal-article","created":{"date-parts":[[2015,3,26]],"date-time":"2015-03-26T09:31:26Z","timestamp":1427362286000},"page":"1823-1830","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":471,"title":["Multidrug-Resistant Candida auris Misidentified as Candida haemulonii: Characterization by Matrix-Assisted Laser Desorption Ionization\u2013Time of Flight Mass Spectrometry and DNA Sequencing and Its Antifungal Susceptibility Profile Variability by Vitek 2, CLSI Broth Microdilution, and Etest Method"],"prefix":"10.1128","volume":"53","author":[{"given":"Shallu","family":"Kathuria","sequence":"first","affiliation":[{"name":"Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pradeep K.","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheshta","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anupam","family":"Prakash","sequence":"additional","affiliation":[{"name":"Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aradhana","family":"Masih","sequence":"additional","affiliation":[{"name":"Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anil","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Amrita Institute of Medical Sciences & Research Centre, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3253-6080","authenticated-orcid":false,"given":"Jacques F.","family":"Meis","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands"},{"name":"Department of Medical Microbiology, Radboudumc, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anuradha","family":"Chowdhary","sequence":"additional","affiliation":[{"name":"Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1016\/B978-0-444-52149-1.00090-2","volume-title":"The yeasts, a taxonomic study","author":"Lachance MA","year":"2011","unstructured":"Lachance MA, Boekhout T, Scorzetti G, Fell JW, Kurtzman CP. 2011. Candida Berkhout, p 987\u20131278. In Kurtzman CP, Fell JW, Boekhout T (ed), The yeasts, a taxonomic study, 5th ed. Elsevier Science B.V., Amsterdam, The Netherlands.","edition":"5"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1348-0421.2008.00083.x"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1086\/597108"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1099\/jmmcr.0.T00018"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00319-11"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid2007.131765"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid1910.130393"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-013-2027-1"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.3109\/13693786.2010.493563"},{"key":"e_1_3_2_11_2","volume-title":"Abstr 54th Intersci Conf Antimicrob Agents Chemother (ICAAC). American Society for Microbiology","author":"Chowdhary A","year":"2014","unstructured":"Chowdhary A, Kathuria S, Prakash A, Meis JF. 2014. Pitfalls in phenotypic identification of Candida auris and comparison of in-vitro susceptibilities using CLSI-BMD and VITEK2, abstr M-1203. Abstr 54th Intersci Conf Antimicrob Agents Chemother (ICAAC). American Society for Microbiology, Washington, DC."},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.38.3.1214-1220.2000"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/molbev\/msr121"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02071-10"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2011.03599.x"},{"key":"e_1_3_2_16_2","volume-title":"CLSI document M27-A3","author":"Clinical and Laboratory Standards Institute (CLSI)","year":"2008","unstructured":"Clinical and Laboratory Standards Institute (CLSI). 2008. Reference method for broth dilution antifungal susceptibility testing of yeasts; approved standard\u20143rd ed. CLSI document M27-A3. CLSI, Wayne, PA.","edition":"3"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01391-08"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02437-10"},{"key":"e_1_3_2_19_2","unstructured":"Reference deleted."},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0732-8893(98)00120-5"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.39.11.2520"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00443-09"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00782-14"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02248-12"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01070-11"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.06440-11"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0114004"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.39.12.4387-4389.2001"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00355-12"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01519-13"}],"container-title":["Journal of Clinical Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/JCM.00367-15","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/JCM.00367-15","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,5]],"date-time":"2022-03-05T12:11:39Z","timestamp":1646482299000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/JCM.00367-15"}},"subtitle":[],"editor":[{"given":"D. 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