Detecting Candida auris in urine specimens
This test should not be used to determine cure or to monitor response to therapy.
Real-Time Polymerase Chain Reaction (PCR)
C. auris
Urine
This test should not be ordered for surveillance purposes. Order CAURS / Candida auris Surveillance, Molecular Detection, PCR, Varies and collect an axilla/groin swab for surveillance.
This test should always be performed in conjunction with fungal culture, order FGEN / Fungal Culture, Routine.
Specimen must arrive within 7 days of collection.
Specimen source is required.
Question ID | Description | Answers |
---|---|---|
SRCAU | Specimen Source |
Supplies: Urine Tubes, 10 mL (T068)
Container/Tube: Plastic, 10-mL urine tube
Specimen Volume: 1 mL
Collection Instructions: Collect a random urine specimen.
If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.
0.5 mL
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Urine | Refrigerated (preferred) | 7 days | |
Frozen | 7 days |
Detecting Candida auris in urine specimens
This test should not be used to determine cure or to monitor response to therapy.
Candida auris can cause serious, and sometimes fatal, infections, is often resistant to one or more classes of antifungal drugs, and inappropriate treatment may occur as it can be misidentified in the laboratory. In addition, C auris appears to be more resistant to disinfection than other yeasts, leading to prolonged survival in the environment, increasing the possibility of transmission in hospitals and nursing homes.
The C auris polymerase chain reaction assay can be used to detect C auris from urine specimens.
Not applicable
A positive result indicates the presence of Candida auris DNA.
A negative result indicates the absence of detectable C auris DNA.
An inhibited result indicates that inhibitors are present in the specimen that could prevent the detection of C auris DNA. A new specimen can be resubmitted under a new order, if desired.
A negative result does not rule out the presence of Candida auris because the organism may be present at levels below the limit of detection for this assay.
This assay detects C auris nucleic acid and, therefore, does not distinguish between viable, disease-related organisms and nucleic acid persisting from prior or treated infection. Test results should be correlated with patient symptoms and clinical presentation before a definitive diagnosis is made.
During test verification, 32 culture isolates of Candida auris, previously identified using the Bruker matrix-assisted laser desorption/ionization time-of-flight mass spectrometer, were tested, and all 32 positively identified as C auris by this polymerase chain reaction (PCR) assay.
Verification studies indicated that the limit of detection (LOD) for C auris spiked into urine was 37 colony-forming units (CFU)/20 mcL reaction. To evaluate the accuracy of the assay, 30 urine specimens were spiked with C auris at 1 log above the LOD and 29/30 were positive (97%) by the PCR assay.
A specificity panel consisting of 78 common skin flora organisms or pathogens (bacteria, yeast, molds, viruses, and parasites) and all were negative by the PCR assay. No positivity was found with any other species of Candida including the closely related Candida duobushaemulonii and Candida haemulonii.
1. Spivak ES, Hanson KE: Candida auris: an emerging fungal pathogen. J Clin Microbiol. 2018 Jan 24;56(2):e01588-17
2. Centers for Disease Control and Prevention (CDC) National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Foodborne, Waterborne, and Environmental Diseases (DFWED): Candida auris. CDC; Updated December 27, 2022. Accessed March 8, 2023. Available at: www.cdc.gov/fungal/candida-auris/index.html
3. Navalkele BD, Revankar S, Chandrasekar P: Candida auris: a worrisome, globally emerging pathogen. Expert Rev Anti Infect Ther. 2017 Sep;15(9):819-827
Genomic DNA is extracted. The extracted DNA is placed on the LightCycler 480 instrument, which amplifies and monitors by fluorescence, the development of target nucleotide sequences after each polymerase chain reaction (PCR) cycle. A specific 269 base pairs target sequence from a portion of the 28S rDNA gene from Candida auris is amplified and the resulting segment is detected by melt-curve analysis using sequence-specific fluorescence resonance energy transfer hybridization probes. An internal control is added to every sample to monitor for extraction and PCR inhibition in the specimen.(Walchak RC, Buckwalter SP, Zinsmaster NM, et al: Candida auris direct detection from surveillance swabs, blood, and urine using a laboratory-developed PCR method. J Fungi (Basel). 2020 Oct 15;6(4):224. doi: 10.3390/jof6040224)
Monday through Sunday
This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.
87481
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
CAURP | Candida auris PCR, U | 95764-7 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
SRCAU | Specimen Source | 31208-2 |
CAURU | C auris PCR, Result, U | 95764-7 |