ArticleCommunications medicine2026
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.
Article in Communications medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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15 authors.
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Abstract
backgroundCandidozyma 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.
methodsBetween 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.
resultsHere 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.
conclusionsTo 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.
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