Candida auris is a rare yeast species with a global threat due to its high virulence, multi-drug resistance, serious nosocomial infections and difficulties in laboratory identification. Cases from many countries have been reported since it was first described in 2009. Recently, C. auris infections have been reported from our country.

This is the first case reported from İzmir in a 59-year-old male patient with advanced diabetic foot infection, hospitalized in the department of orthopedics. The patient who underwent bilateral femoropopliteal bypass operation in another center was diagnosed with diabetic foot. The patient had non-healing necrotic wounds, and has a history of Type 1 diabetes, hypertension, hyperlipidemia, and coronary artery disease. In the surgical operation, the right 2nd metatarsal and phalanx of the patient were removed and the necrotic tissue was debrided. Yeast and gram negative bacterial cells were observed in the microbiological evaluation of tissue samples taken from the wound, and the species identification was made with culture and MALDI-TOF MS. Empirical tazocin and linezolid therapy were given to patient. The patient was amputated approximately 15 cm distal to the knee joint due to the ongoing wound discharge and necrosis in the postoperative period.

Yeast and bacterial colonies grown in culture were identified by MALDI-TOF MS as C. Auris, Klebsiella aerogenes and Pseudomonas aureginosa. C. auris was confirmed with 99% homology as a result of ITS region sequence analysis. In the antifungal susceptibility study, MIC values for fluconazole, amphotericin B and caspofungin were >64 μg/ml, 2 μg/ml and 0.25 μg/ml respectively. C. auris growth was not detected in the swab samples taken from the tissue around the wound where the knee joint was amputated approximately 15 cm distal and in the nasal swab sample. Possible improvement was considered for this patient with below-knee amputation.

From now on, C. auris infections should be kept in mind in our country. MALDI-TOF-MS provides great convenience in accurate identification and determination of the true prevalence of C.auris. Since diabetes is one of the most important predisposing factors in C. auris infection, it should be kept in mind as a factor in diabetic foot infections.