# Emergence of Candida (Candidozyma) auris in Minas Gerais, Brazil: Genomic Surveillance to Guide Rapid Public Health Responses

## TL;DR

This study reports the first genomic surveillance of Candida auris in Minas Gerais, Brazil, revealing its origin and transmission during a hospital outbreak.

## Contribution

The study provides the first genomic characterization of C. auris in Minas Gerais and identifies a fluconazole resistance mutation linked to transmission dynamics.

## Key findings

- All C. auris isolates belonged to clade IV and were genetically similar to strains from northern Colombia.
- One isolate carried the ERG11 Y132F mutation, indicating fluconazole resistance, while environmental isolates clustered with clinical strains, suggesting surface-mediated transmission.

## Abstract

Candida (Candidozyma) auris is an emerging yeast that poses a significant global health threat due to its multidrug resistance and ability to cause healthcare‐associated outbreaks. Genomic surveillance is essential for monitoring spread, transmission and antifungal resistance.

To report the first identification and genomic characterisation of
C. auris
in the state of Minas Gerais, Southeast Brazil, and to investigate the genetic origin and diversity, resistance‐associated mutations, and potential transmission dynamics during a hospital outbreak.

Eight
C. auris
isolates were collected during a hospital outbreak in Belo Horizonte, Minas Gerais, Brazil, including clinical samples from patients and environmental samples from surfaces in the Intensive Care Unit (ICU). Epidemiological investigation, whole‐genome sequencing (WGS) and phylogenomic analyses were conducted to determine circulating clade, genetic diversity, outbreak origin and the presence of antifungal resistance mutations.

All isolates were classified as clade IV and exhibited high genomic similarity to strains previously reported in northern Colombia (Caribbean coast). One isolate carried the ERG11 Y132F mutation, associated with fluconazole resistance, but this mutation was absent in another isolate from the same patient collected 1 day earlier, indicating mixed fungal populations. Environmental isolates clustered tightly with clinical strains, supporting surface‐mediated transmission in the ICU.

This study describes the introduction and local spread of clade IV
C. auris
in Minas Gerais, Brazil. The findings underscore the critical role of genomic surveillance in identifying resistance mechanisms, tracing transmission pathways and guiding public health responses.