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Candida auris Treatment — SCE Infectious Diseases MCQ

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ModerateFungal InfectionsCandida auris TreatmentSCE Infectious Diseases

A 45-year-old man on the haematology ward develops invasive candidiasis with Candida auris identified from blood cultures. The isolate shows Fluconazole MIC >256 mg/L, Amphotericin B MIC 2 mg/L (intermediate), and Caspofungin MIC 0.5 mg/L (susceptible). What is the recommended treatment?

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Correct answer: A — Caspofungin IV (or another echinocandin) — guided by MIC as the isolate is susceptible

C. auris is intrinsically resistant to Fluconazole (>90% of isolates) and frequently shows elevated Amphotericin B MICs. Echinocandins are the treatment of choice when susceptible (which this isolate is — Caspofungin MIC 0.5). However, C. auris can develop echinocandin resistance during treatment, so repeat susceptibility testing should be performed if the patient does not respond. C. auris requires enhanced IPC measures (single-room isolation, contact precautions, Chlorhexidine body wash, terminal clean with chlorine-based agent).

Reference: UKHSA 2024 – C. auris guidance; ESCMID 2024 – Candida guidelines