Molecular Typing of Candida auris Isolates from Intensive Care Units in Lagos University Teaching Hospital

Candida auris is an emerging multidrug-resistant fungal pathogen of global concern, increasingly reported from intensive care units (ICUs) and causing healthcare-associated outbreaks with high mortality rates. Reports of C. auris in sub-Saharan African ICUs remain limited, creating significant gaps in epidemiological understanding. This study molecularly typed Candida auris isolates from patients admitted to the ICUs of Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos State, Southwest Nigeria. Fungal swabs from catheter tips, skin, and environmental surfaces were cultured on CHROMagar Candida Plus medium. Identification was confirmed by matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry and ITS1/ITS2 sequencing. Whole-genome sequencing was used for clade assignment. Eleven C. auris isolates were identified over a 12-month period. Clade I (South Asian) predominated, with partial clustering in two patient cohorts suggesting nosocomial transmission. All isolates demonstrated reduced susceptibility to fluconazole, with two showing pan-azole resistance. Infection prevention and control gaps contributed to persistence in ICU environments. These results provide important baseline data on C. auris epidemiology in a major Southwest Nigerian tertiary hospital. Keywords: Candida auris, molecular typing, ICU, Lagos, antifungal resistance.