Accurate PCR-based identification of Candida auris infections using oligonucleotides based on auris-specific GPI-protein encoding genes
Objectives: 
Candida auris is an emerging pathogen that is increasingly being identified as cause of life-threatening systemic infections in human societies around the world. Due to its low susceptibility to antifungal compounds, mortality rates of C. auris are high and, therefore, rapid and accurate diagnosis is crucial to successfully cure infected patients and to control outbreaks of C. auris. With the current methodologies available in most hospitals, achieving accurate species-level diagnosis of C. auris infections is complicated and has led to misidentifications with direct consequences for treatment and curing prospective.  The aim of our study was to provide a new and easily accessible diagnostic tool for rapid and reliable identification of Candida auris infections.  Methods: By in silico predicting GPI proteins in C. auris on a genome-wide scale, and subsequently designing oligonucleotides for auris-specific GPI protein-encoding genes and then applying these in a rapid colony PCR method, we intent to develop a new diagnostic tool for identification of C. auris infections  Results:
We show that C. auris isolates are easily and reliably identified by our PCR method. Robustness of the method was verified by blind testing of a library of 142 clinical isolates including 113 C. auris isolates (55 blood isolates and 58 isolates from other body sites) from a Spanish hospital (La Fe, Valencia), 27 C. auris isolates derived from hospitals in various countries (Spain, India, Colombia, Brazil, Japan, and Korea), and two non-auris isolates as negative controls. Specificity of the primers for C. auris was also validated using a set of representative Candida species including the clinically most important (e.g. C. albicans, C. parapsilosis and C. glabrata) and the phylogenetically more related C. lusitaniae and C. haemulonii. Moreover, we show that isolates that were not or not reliably identified by MALDI-TOF MS identification are correctly identified by our PCR approach.