LETTER TO THE EDITOR
Urgent Need for Genomic Surveillance of Candida auris in Iran
Sahar Khodashenas1
, Mojtaba Didedar1*
¹ Department of Medical Parasitology and Mycology, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran
*Corresponding author: Mojtaba Didedar, Department of Medical Parasitology and Mycology, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran. Email: didehdar_m@yahoo.com
DOI: 10.22034/cmja.16.1.1
How to Cite this Article:
Khodashenas S, Didedar M. Urgent Need for Genomic Surveillance of Candida auris in Iran. Complement Med J. 2026;16(1):1–3. DOI: 10.22034/cmja.16.1.1
Abstract
This article has no abstract.
Keywords: Candida auris, Iran
Received: 05 January 2026 | Accepted: 20 April 2026
Dear Editor,
The increasing identification of Candida auris in hospitals in Iran represents an important challenge for national infection-control policies. Evidence from recent studies indicates that most isolates reported in the country belong to clade V, a clade associated with high fluconazole resistance and concerns about reduced susceptibility to amphotericin B. This resistance pattern limits available treatment options and increases the risk of hospital transmission (1, 2).
Despite the clinical importance of this pathogen, many laboratories continue to use conventional phenotypic methods for identification. These methods are susceptible to misidentification and do not allow clade assignment or the detection of resistance-associated mutations. Consequently, transmission events and resistant clones may go undetected.
Whole-genome sequencing (WGS) is an effective approach to overcoming these limitations. Countries that have incorporated WGS into their surveillance systems have been able to detect outbreaks more rapidly, respond in a timely manner, and strengthen evidence-based control measures. In Iran, where clade V appears to be predominant, genomic surveillance has a vital role in guiding the rational use of antifungal drugs and public-health interventions (3).
Accordingly, we recommend that national health authorities and academic centers prioritize the establishment of a coordinated national WGS-based surveillance program for Candida auris. Such a program could support the early identification of high-risk strains, assist hospital infection-control teams, and improve policy-making at the national level.
References
- Chow NA, De Groot T, Badali H, Abastabar M, Chiller TM, Meis JF. Potential fifth clade of Candida auris, Iran, 2018. Emerg Infect Dis. 2019;25(9):1780. doi: 10.3201/eid2509.190686
- Spruijtenburg B, Badali H, Abastabar M, Mirhendi H, Khodavaisy S, Sharifisooraki J, et al. Confirmation of fifth Candida auris clade by whole genome sequencing. Emerg Microbes Infect. 2022;11(1):2405–2411. doi: 10.1080/22221751.2022.2125349
- Douglas AP, Stewart AG, Halliday CL, Chen SC-A. Outbreaks of fungal infections in hospitals: epidemiology, detection, and management. J Fungi. 2023;9(11):1059. doi: 10.3390/jof9111059