# First report of Candida (Candidozyma) auris infections in a human and a dolphin from the Dominican Republic: A One health perspective

## TL;DR

This paper reports the first cases of Candida auris in the Dominican Republic, found in both a human and a dolphin, highlighting the need for a One Health approach to track and control the infection.

## Contribution

The study is the first to report C. auris in the Dominican Republic and in a dolphin, emphasizing cross-species transmission and the need for integrated health strategies.

## Key findings

- C. auris was isolated from both a human and a dolphin in the Dominican Republic.
- The dolphin isolate showed high fluconazole resistance but low resistance to newer antifungals.
- Genome sequencing revealed no known resistance mutations, suggesting alternative resistance mechanisms.

## Abstract

This study documents the first reported cases of Candida (Candidozyma)auris in the Dominican Republic, isolated from both a critically ill human patient and a captive dolphin. Antifungal susceptibility testing from dolphin isolate showed elevated minimum inhibitory concentrations (MIC) of fluconazole but low MICs of other antifungals, including the novel drugs rezafungin, ibrexafungerp and manogepix. Whole genome sequencing (WGS) of the dolphin isolate allocated it to clade I, but surprisingly did not show any known mutations that confer azole resistance, suggesting a mechanism different from mutations in the genes studied. The concurrent emergence of C. auris in human and animal hosts underscores the importance of a One Health approach, emphasizing the interconnectedness of human, animal, and environmental health, and the need for strengthened surveillance and rigorous infection control measures across medical and veterinary settings.