What is the role of empirical treatment for suspected invasive candidiasis in non-neutropenic non transplanted patients in the intensive care unit?-Empiricus strikes back!

Validation and implementation of a commercial real-time PCR assay for direct detection of Candida auris from surveillance samples

BACKGROUND

Rapid and reliable laboratory methods are required for detecting the nosocomial yeast Candida auris. AurisID^® (Olm Diagnostics) is a real-time PCR assay approved for detecting C. auris in fungal cultures and directly from blood samples, involving a nucleic acid extraction as a prior step.

OBJECTIVES

The purpose of this study is to validate the AurisID^® kit for direct detection of C. auris from surveillance samples without prior DNA extraction and to analyse the results of implementing this methodology to our daily laboratory routine protocol for C. auris surveillance studies.

METHODS

Our PCR method using the AurisID^® kit was compared with our routine protocol, consisting of culture in CHROMagar^® Candida and identification by mass spectrometry. A total of 113 swabs were used for validation and 136 pair of surveillance samples were tested. Limit of detection (LOD) was determined by using swabs in Amies transport medium, which were spiked in a series of dilutions of a C. auris standardised suspension (0.5 McFarland).

RESULTS

The PCR method showed high sensitivity, specificity, predictive positive value and predictive negative value (96.6%, 100%, 100% and 98.2%, respectively) when compared with the routine protocol. LOD was 500 CFU/ml, which corresponds to approximately 1 CFU/PCR.

CONCLUSIONS

Our PCR method using the AurisID^® kit allows a reduction in the turnaround time for surveillance of C. auris compared with other methods. These results are expected to contribute to control C. auris outbreaks, allowing isolation of patients and cleaning of environmental surfaces in advance.