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Background <p><i>Candidozyma auris (C auris</i>) is an opportunistic, multidrug-resistant fungus associated with a high mortality rate and sustained transmission in both healthcare and environment settings, representing significant public health concerns. Genomic studies have identified distinct clades of <i>C auris</i>, each with specific antifungal resistance traits. This study evaluated the potential of wastewater surveillance for the detection and clade-level characterization of <i>C auris</i>.</p> Methods <p>Between March 2023 and February 2024, a total of 23,212 wastewater samples were systematically collected from multiple sampling sites across Abu Dhabi and Al Ain. Isolates were confirmed by Matrix-Assisted Laser Desorption/Ionization–Time of Flight Mass Spectrometry and subsequently characterized through whole-genome sequencing (WGS) for taxonomic resolution. Antifungal susceptibility testing was performed by broth microdilution.</p> Results <p>Here we demonstrate direct culture-based isolation of ten <i>C auris</i> positives ( ~ 4 per 10,000 samples). Phylogenetic and mating-type analyses classify nine isolates as Clade I and one as Clade VI. WGS further reveals <i>ERG11</i> gene mutation in the clade VI isolate, conferring azole resistance. Antifungal susceptibility testing by broth microdilution reveals elevated Minimum Inhibitory concentration (MIC) to at least one antifungal drug in all isolates studied, while two isolates exhibited elevated MICs to agents spanning more than two drug classes.</p> Conclusions <p>To our best of knowledge, these findings represent the first regional detection of Clade VI <i>C auris</i>, highlighting wastewater surveillance as a valuable complementary tool for healthcare-based monitoring. Such approaches can provide insights into the transmission dynamics and antifungal resistance of emerging <i>C auris</i> clades that may otherwise remain undetected until its clinical detection.</p>

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Isolation and Genomic Profiling of Multi-Drug-Resistant pathogen Candidozyma auris, Including the New Clade VI, Through Wastewater Surveillance in Abu Dhabi, United Arab Emirates

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月15日

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  • Vinay Kusuma,
  • Sumayya Almansoori,
  • Bhuvaneshkumar Shanmugam,
  • Surabhi Singh,
  • Maryam AlQaydi,
  • Siba Moussa,
  • Grzegorz Brudecki,
  • Shilp Purohit,
  • Sharika Pariyachery,
  • Shalini Behl,
  • Samara Bin Salem,
  • Tiago Magalhaes,
  • Thyago Cardoso,
  • Javier Quilez,
  • Wael Elamin

摘要

Background

Candidozyma auris (C auris) is an opportunistic, multidrug-resistant fungus associated with a high mortality rate and sustained transmission in both healthcare and environment settings, representing significant public health concerns. Genomic studies have identified distinct clades of C auris, each with specific antifungal resistance traits. This study evaluated the potential of wastewater surveillance for the detection and clade-level characterization of C auris.

Methods

Between March 2023 and February 2024, a total of 23,212 wastewater samples were systematically collected from multiple sampling sites across Abu Dhabi and Al Ain. Isolates were confirmed by Matrix-Assisted Laser Desorption/Ionization–Time of Flight Mass Spectrometry and subsequently characterized through whole-genome sequencing (WGS) for taxonomic resolution. Antifungal susceptibility testing was performed by broth microdilution.

Results

Here we demonstrate direct culture-based isolation of ten C auris positives ( ~ 4 per 10,000 samples). Phylogenetic and mating-type analyses classify nine isolates as Clade I and one as Clade VI. WGS further reveals ERG11 gene mutation in the clade VI isolate, conferring azole resistance. Antifungal susceptibility testing by broth microdilution reveals elevated Minimum Inhibitory concentration (MIC) to at least one antifungal drug in all isolates studied, while two isolates exhibited elevated MICs to agents spanning more than two drug classes.

Conclusions

To our best of knowledge, these findings represent the first regional detection of Clade VI C auris, highlighting wastewater surveillance as a valuable complementary tool for healthcare-based monitoring. Such approaches can provide insights into the transmission dynamics and antifungal resistance of emerging C auris clades that may otherwise remain undetected until its clinical detection.