Genetic Heterogeneity of Australian Candida auris Isolates: Insights From a Nonoutbreak Setting Using Whole-Genome Sequencing

Chayanika Biswas; Qinning Wang; Sebastiaan J van Hal; David W Eyre; Bernard Hudson; Catriona L Halliday; Krystyna Mazsewska; Alice Kizny Gordon; Andie Lee; Laszlo Irinyi; Christopher H Heath; Arunaloke Chakrabarti; Nelesh P Govender; Wieland Meyer; Vitali Sintchenko; Sharon C-A Chen

doi:10.1093/ofid/ofaa158

Genetic Heterogeneity of Australian Candida auris Isolates: Insights From a Nonoutbreak Setting Using Whole-Genome Sequencing

Open Forum Infect Dis. 2020 May 7;7(5):ofaa158. doi: 10.1093/ofid/ofaa158. eCollection 2020 May.

Authors

Chayanika Biswas^{1

2}, Qinning Wang^{1

2}, Sebastiaan J van Hal³, David W Eyre⁴, Bernard Hudson⁵, Catriona L Halliday^{2

6}, Krystyna Mazsewska^{6

7}, Alice Kizny Gordon⁵, Andie Lee³, Laszlo Irinyi^{6

7}, Christopher H Heath⁸, Arunaloke Chakrabarti⁹, Nelesh P Govender¹⁰, Wieland Meyer^{1

5

6}, Vitali Sintchenko^{1

2

5}, Sharon C-A Chen^{1

2

5

6}

Affiliations

¹ Centre for Infectious Diseases and Microbiology - Public Health, Westmead Hospital, The University of Sydney, Sydney, Australia.
² Center for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Sydney, Australia.
³ Deparment of Infectious Diseases and Microbiology, New South Wales Health Pathology, The Royal Prince Alfred Hospital, Sydney, Australia.
⁴ Big Data Institute, University of Oxford, Oxford, United Kingdom.
⁵ Department of Microbiology, Royal North Shore Hospital, New South Wales Health Pathology, Sydney, Australia.
⁶ Marie Bashir Institute for Emerging Infections and Biosecurity, The University of Sydney, Sydney, Australia.
⁷ Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Faculty of Medicine and Health, Westmead Clinical School and the Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia.
⁸ Department of Microbiology, Fiona Stanley Hospital Network, PathWest Laboratory Medicine, and the Department of Infectious Diseases, Fiona Stanley Hospital, Perth, Australia.
⁹ Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
¹⁰ National Institute for Communicable Diseases, Division of the National Health Laboratory Service and Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.

Abstract

Whole-genome sequencing clustered Australian Candida auris isolates from sporadic cases within clade III. Case isolates were genomically distinct; however, unexpectedly, those from 1 case comprised 2 groups separated by >60 single nucleotide polymorphisms (SNPs) with no isolate being identical, in contrast to outbreaks where isolates from any 1 individual have differed by <3 SNPs. Multidrug resistance was absent. High within-host genetic heterogeneity should be considered when investigating C. auris infections.

Keywords: Candida auris; drug resistance; whole-genome sequencing.