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.