Investigation of the Physiological, Biochemical and Antifungal Susceptibility Properties of Candida auris



Candida auris is an emerging pathogen associated with outbreaks in clinical settings. Isolates of the pathogen have been geographically clustered into four clades with high intra-clade clonality. Pathogenicity varies among the clades, highlighting the importance of understanding these differences.


To examine the physiological and biochemical properties of each clade of C. auris to improve our understanding of the fungus.


Optimal growth temperatures of four strains from three clades, East Asia, South Asia and South Africa, were explored. Moreover, assimilation and antifungal susceptibility properties of 22 C. auris strains from the three clades were studied.


The optimal growth temperatures of all strains were 35–37 °C. Assimilation testing demonstrated that the commercial API ID 32 C system can be used to reliably identify C. auris based on the biochemical properties of the yeast. Notably, C. auris can be uniquely differentiated from commonly clinical fungi by its ability to assimilate raffinose and inability to utilize D-xylose, suggesting a useful simple screening tool. The antifungal susceptibility results revealed that all strains are resistant against fluconazole (minimal inhibitory concentration (MIC) 4 to > 64 µg/mL) and miconazole (MIC 8 to > 16 µg/mL), with strains from the Japanese lineage showing relatively lower MIC values (1–4 µg/mL). Conversely, itraconazole, voriconazole, amphotericin B, micafungin and caspofungin were active against most of the tested strains. On the clade level, East Asian strains generally showed lower MICs against azoles comparing to the other clades, while they displayed MICs against flucytosine higher than those of strains from South Africa and South Asia clades.


Our data suggest a simple identification approach of C. auris based on its physiological and biochemical properties and highlight aspects of C. auris population from various clades.

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The authors express their sincere appreciation for those who have provided some of the fungal strains.


This work was supported in part by the Emerging/Re-emerging Infectious Disease Project of the Japan Agency for Medical Research and Development, AMED (JP20fk108094).

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Correspondence to Koichi Makimura.

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AMR Mycosis Control Research in the Environment of Treatment and Education for Physically and Mentally Handicapped Persons is an endowed department supported with an unrestricted grant from the Social Welfare Corporation Hirakata Ryoikuen.

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Du, M., Hu, W., Tamura, T. et al. Investigation of the Physiological, Biochemical and Antifungal Susceptibility Properties of Candida auris. Mycopathologia (2021).

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  • Candida auris
  • Identification
  • Assimilation
  • API ID 32 C
  • Susceptibility