Emergence of pan-drug resistant Candidozyma auris in Kenya, the second globally documented case

Candidozyma auris is a World Health Organization high-priority fungal pathogen due to nosocomial transmission, environmental persistence, and multidrug resistance. Pan-drug-resistant (PDR) isolates, resistant to four antifungal classes, are exceedingly rare, previously reported from a single patient in New York, USA (2022). We report phenotypic and genomic features of a PDR C. auris isolate from Kenya, the second globally. A fungal isolate from a 28-year-old inpatient with a hospital-acquired surgical site infection was identified and tested using VITEK 2. Whole-genome sequencing using Illumina NextSeq 1000, and variant analysis were performed against reference strain B8441. The isolate was resistant to azoles (fluconazole MIC ≥ 64 mg/L), echinocandins (micafungin MIC > 8 mg/L), polyenes (amphotericin B MIC 2 mg/L), and flucytosine (MIC ≥ 64 mg/L). It belonged to Clade I, and harbored ERG11 Y132F, CDR1 E709D, FKS1 S639F, and FUR1 stop-gain mutations. This finding signals an escalating resistance threat and underscores urgent need for antifungal stewardship.