First Detection of Candidozyma (Candida) auris in Wastewater in Türkiye: Evidence for Environmental Circulation under a One-Health Framework
Water, Air, and Soil Pollution, cilt.237, sa.23, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 237 Sayı: 23
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s11270-026-10043-z
- Dergi Adı: Water, Air, and Soil Pollution
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, ABI/INFORM, Artic & Antarctic Regions, BIOSIS, CAB Abstracts, Chemical Abstracts Core, Chimica, Compendex, EMBASE, Environment Index, Geobase, Greenfile, Zoological Record, Natural Science Collection (ProQuest), Biomedical Reference Collection: Corporate Edition (EBSCO), Earth, Atmospheric, & Aquatic Science Collection (ProQuest), Health Research Premium Collection (ProQuest)
- Anahtar Kelimeler: Candida auris, Candidozyma auris, Culture, Hospital, One Health, QPCR, Wastewater
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Ankara Hacı Bayram Veli Üniversitesi Adresli: Evet
Özet
Candidozyma (Candida) auris is an emerging multidrug-resistant fungal pathogen with expanding ecological presence beyond healthcare settings. Wastewater-based surveillance (WBS) has recently become an important tool for early detection of community-level circulation. However, no environmental monitoring data have previously been reported from Türkiye. This study aimed to investigate the presence of C. auris in hospital-associated wastewater and assess its potential role as an environmental reservoir. Between January and July 2025, 46 wastewater samples were collected twice weekly from the main outlet of a tertiary hospital. Samples underwent concentration, culture on selective chromogenic agar, and matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS) confirmation. DNA extracted from Sterivex filters was tested using the species-specific CauF/CauR qPCR assay. All runs included appropriate positive, negative, and no-template controls. The Bio-speedy Candida auris Clade Detection qPCR Kit (Bioeksen R&D Technologies Inc., Türkiye) was used for clade identification of the isolates. Antifungal susceptibility testing of the recovered C. auris isolates was performed using the EUCAST reference microdilution method, and minimum inhibitory concentrations (MICs) were interpreted according to EUCAST guidelines. C. auris DNA was detected in three wastewater samples (Ct 31–36), and two culture-confirmed isolates were recovered and stored. The repeated qPCR positivity across different sampling dates suggests intermittent yet detectable shedding into the sewage system. Importantly, no outbreak was ongoing in the hospital, with only sporadic clinical cases reported, indicating that even low-level colonization may generate measurable environmental signatures. All isolates were evaluated as Clade-1. Antifungal susceptibility testing revealed high fluconazole MICs (> 64 mg/L) in both C. auris isolates, consistent with no activity of fluconazole. In contrast, low MIC values for echinocandins (anidulafungin 0.06–0.25 mg/L; micafungin 0.125–0.25 mg/L) indicated favorable in vitro activity of this antifungal class against the tested isolates. This study provides the first culture-confirmed detection of C. auris in wastewater in a tertiary hospital in Türkiye, demonstrating organism persistence under local wastewater conditions. These findings highlight the value of WBS as an early-warning component of fungal surveillance and underscore the need to integrate environmental monitoring into One Health strategies for C. auris.