Candida auris Isolate Submission and Laboratory Testing

On this page:
Criteria for submission of isolates
Appropriate specimen types
Specimen submission forms
Shipping to MDH-PHL
Laboratory testing
Questions

Criteria for submission of isolates

Submission of Candida auris clinical materials or isolates to MDH is required.

• C. auris isolates from any body site (e.g., urine, blood, ear, wound, skin, etc.) must be submitted to the MDH-PHL, along with any antifungal susceptibility testing performed.
• C. auris can be misidentified with the phenotypic methods for yeast identification used by most clinical laboratories. The MDH-PHL is equipped to identify C. auris, and clinical laboratories should forward suspected or confirmed isolates to the MDH-PHL.
  • C. auris is most commonly misidentified as Candida haemulonii, but the potential misidentifications are specific to each yeast identification method. For more detailed information regarding possible misidentification, visit CDC: Identification of C. auris.
• If your lab identifies a Candida species that may be a C. auris misidentification based on CDC’s guidance, we ask that those isolates be sent to MDH-PHL for further characterization.
• Many clinical laboratories do not typically determine the species of isolates from non-sterile sites since the presence of Candida in these sites may represent colonization rather than infection and would not require treatment. However, C. auris is important to identify even from a non-sterile body site because the presence of C. auris in any body site can represent wider colonization, posing a risk for transmission and requiring implementation of infection control precautions.
• When Candida is isolated from non-sterile sites, species-level identification can be considered in certain circumstances, including:
  • When clinically indicated in the care of a patient.
  • When a case of C. auris infection or colonization has been detected in a facility or unit, in order to detect additional patients colonized.
  • When a patient has had an overnight stay in a health care facility outside the United States in the previous one year, especially if in a country with documented C. auris transmission. Visit CDC: Tracking C. auris for a map of countries with reported cases.
• If your facility does not identify yeast to the species level, MDH is available for consultation. Isolates of interest can be submitted to the PHL for identification.

Appropriate specimen types

• Send on any media that supports the growth of yeast.

Specimen submission forms

MDH-PHL requests the following documentation to be included with each isolate submission:

• Infectious Disease Laboratory Submission Form (PDF)
  More information can be found on Forms for the Infectious Disease Laboratory
  • Be sure to include the following information:
    • project number (2180)
    • patient information
    • facility information
    • specimen source
    • collection date
    • isolate genus/species (if available)
• Antifungal Susceptibility Testing Report:
  • If available, submit a copy of susceptibility testing results performed in your laboratory (automated, Etest, MIC, etc.)

Shipping to MDH-PHL

• Ship specimens to MDH-PHL by an overnight delivery service or local courier.
  Note: It is the responsibility of the submitting laboratory to determine the appropriate packaging and shipping for patient specimens and culture isolates. See U.S. Department of Transportation Regulations: Hazardous materials shipping for more information.
   
• Isolates should be shipped at room temperature.
   
• Ship to:
  Minnesota Department of Health
  Public Health Laboratory
  Attn: Biological Accessioning
  601 Robert St. N
  St. Paul, Minnesota 55155-2531

Laboratory testing

• MDH-PHL performs testing on submitted isolates.
  C. auris identification is confirmed by MALDI-TOF Mass Spectrometry.

Questions?

MDH-PHL Special Microbiology Laboratory is available during regular business hours for consultation on Candida auris testing and result interpretation at 651-201-5073.