Mixed Candida auris Strain Infections in China

The multidrug-resistant fungal pathogen Candida auris poses an increasing global health threat due to its high transmissibility and persistence in healthcare environments. This study reports five cases of mixed C. auris-strain infections in China, involving co-infection with two phenotypically and genetically distinct C. auris strains. In two patients, strains from different genetic clades (I and III) were identified, while three patients harbored strains from the same clade, but showing nucleotide variations. Comparative analyses revealed notable differences in biofilm formation, environmental survival, and secretion of virulence factors between the co-infecting strains of C. auris. These biological and genetic disparities may present significant challenges for the diagnosis and treatment of C. auris infections.