-
Identify the type of specimen required:
a. Blood cultures - for suspected bloodstream infections.
b. Respiratory samples - for suspected lung infections.
c. Urine - for suspected urinary tract infections.
d. Wound swabs or tissue - for suspected skin or soft tissue infections.
e. Sterile body fluids - for suspected infections in normally sterile sites (e.g., cerebrospinal fluid, pleural fluid, peritoneal fluid). -
Specimen transport and storage:
Properly label the specimens with the patient's identification, date, and time of collection. Transport specimens to the laboratory as soon as possible, maintaining appropriate storage conditions (room temperature or refrigerated, as needed).
-
Laboratory diagnostics:
a. Culture - The specimen is inoculated onto selective agar media (e.g., CHROMagar Candida) and incubated at 35-37°C for 24-48 hours. Positive cultures will show colonies of Candida auris, which can be further identified by their characteristic appearance and color. b. Identification - Confirmatory identification of Candida auris can be done using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), or molecular methods, such as polymerase chain reaction (PCR) and DNA sequencing. c. Antifungal susceptibility testing - This testing is performed to determine the susceptibility of the isolate to various antifungal agents and guide appropriate treatment. The Clinical and Laboratory Standards Institute (CLSI) or the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines can be followed for testing and interpretation.
-
Collection of specimens:
a. Blood cultures - Collect two sets of blood cultures (each set consists of aerobic and anaerobic bottles) from different venipuncture sites, using proper skin antisepsis.
b. Respiratory samples - Collect sputum, endotracheal aspirate, or bronchoalveolar lavage samples using sterile containers.
c. Urine - Collect a midstream, clean-catch urine sample in a sterile container.
d. Wound swabs or tissue - Use a sterile swab to sample the wound or collect a tissue biopsy.
e. Sterile body fluids - Collect fluids using appropriate sterile techniques, such as lumbar puncture, thoracentesis, or paracentesis. -
Reporting results:
The laboratory will report the results of the culture, identification, and antifungal susceptibility testing to the healthcare provider, who will then determine the appropriate treatment course based on these findings.