Praxis Medical Insights

Est. 2024 • Clinical Guidelines Distilled

Made possible by volunteer editors from the University of Calgary & University of Alberta

Last Updated: 10/22/2025

Laboratory Testing for Candida auris Diagnosis

Primary Diagnostic Approach

  • The European Society of Clinical Microbiology and Infectious Diseases recommends collecting 2-3 blood culture sets with 20 mL blood volume per set when investigating potential candidemia, as diagnostic yield increases with blood volume and number of bottles 1, 2
  • The Infectious Diseases Society of America suggests using automated validated blood culture systems, as these are strongly recommended over older methods 3
  • Blood cultures have approximately 50% overall sensitivity for invasive candidiasis and median time to positivity of 2-3 days (range 1 to ≥7 days), according to the Clinical Infectious Diseases guidelines 4

Species Identification

  • The Centers for Disease Control and Prevention strongly recommends species-level identification for all Candida isolates to guide treatment, detect outbreaks, and conduct surveillance 1, 2
  • The European Society of Clinical Microbiology and Infectious Diseases recommends MALDI-TOF MS as the primary identification method for cultured isolates, provided the spectral database includes C. auris 1, 2
  • The Clinical and Laboratory Standards Institute strongly recommends DNA sequencing, particularly in specialized laboratories or when MALDI-TOF cannot provide identification 1, 2

Adjunctive Diagnostic Methods

  • The European Society of Clinical Microbiology and Infectious Diseases strongly recommends chromogenic agars for detecting mixed yeast infections and can provide presumptive identification 1, 2
  • The Infectious Diseases Society of America recommends β-D-glucan (BDG) testing for candidemia detection with sensitivity >65% and specificity >80% at cutoff 80 pg/mL 6, 3
  • The Clinical Infectious Diseases guidelines suggest serial determinations of BDG twice weekly, particularly useful for ruling out infection (negative predictive value >85%) 6, 3

Antifungal Susceptibility Testing

  • The European Committee on Antimicrobial Susceptibility Testing or Clinical and Laboratory Standards Institute antifungal susceptibility testing is strongly recommended for all C. auris isolates given the high rates of multidrug resistance 1, 2
  • The Centers for Disease Control and Prevention has defined tentative breakpoints for interpreting CLSI broth microdilution results specifically for C. auris 1, 2

REFERENCES

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