Candida auris can be identified accurately

I read with interest the recent CMAJ article by Schwartz and Dingle, which gives a good synopsis of Candida auris.¹ However, the authors’ claim that certain matrix-assisted laser desorption/ionization time of flight (MALDI-TOF) mass spectrometry identification systems can misidentify C. auris is somewhat misleading.

The article by Tsay and colleagues² cited by Schwartz and Dingle states that accurate identification for C. auris can be performed by VITEK MS and Bruker Biotyper MALDI-TOF mass spectrometry. Public Health Ontario also states that these 2 methods can identify C. auris.³ Furthermore, a recent study of 50 molecularly confirmed C. auris isolates from different geographical areas showed 100% accurate identification by MALDI-TOF mass spectrometry.⁴ Despite the small sample, that is more than the 19 cases of C. auris identified in Canada since 2012.¹

I would like to gently caution that Schwartz and Dingle’s misleading claim could lead to clinicians and laboratorians unnecessarily questioning the identification of Candida species by MALDI-TOF mass spectrometry, and consequently overtesting and misusing resources. Patients may also be misled, which is not helpful in establishing good physician–patient rapport.