Abstract: Objective The first case of blood stream infection with Candida auris in Tongling of Anhui province was reported, the drug resistance and source of the strain were analyzed. Methods MS and gene sequencing were used to identify the strain of Candida auris from a patient with blood infection in the intensive care unit (ICU) of a tertiary hospital in Anhui Province, China, and its resistanceto various drugs, bacterial origin and virulence were analysed. Results The drug sensitivity test showed that the fungus was resistant to azoles and polyene, but sensitive to 5-fluorocytosine.Mutations in ERG11 and CDR1 were found in the whole genome sequencing. The former mutated from tyrosine to L-Phenylalanine at position 132 and the latter mutated from glutamate to L-Aspartic Acid at position 709.No mutation was detected in ergosterol pathway related genes ERG1, ERG2, ERG6, Erg13. In addition, a phylogenetic tree drawn by comparing Internally Transcribed Spaer（ITS）sequences revealed that the strain with the closest relationship to the strains we isolated was the Indian strain. Conclusion This is the first report of blood stream infection caused by Candida auris in Anhui Province.MS and gene sequencing enable accurate identification of Candida auris. In addition, gene sequencing enables in-depth analysis of the species origin, resistance to multiple drugs, and high virulence of Candida auris.

Key words: Candida auris, Bloodstream infection, Drug resistance, Gene sequencing