Candida auris candidemia in a critically ill pediatric trauma patient managed in Jordan: a case report with whole-genome sequencing

Candida auris (also known as Candidozyma auris ) is an emerging multidrug-resistant fungal pathogen that poses a growing threat to global public health, driving healthcare-associated outbreaks and confounding routine diagnostic workflows. Its capacity to persist on environmental surfaces and medical equipment, colonize patients asymptomatically, and spread readily within healthcare settings makes it exceptionally difficult to control, particularly among critically ill patients. Cases arising in conflict-affected populations undergoing fragmented, cross-border care remain especially poorly characterized, despite representing a scenario of heightened risk. We report a case of C. auris bloodstream infection in a 5-year-old child from the Gaza Strip, managed in Jordan following war-related trauma. The child’s clinical course was complicated by hydrocephalus requiring external ventricular drain placement, recurrent infections, multiple device replacements, prolonged pediatric intensive care unit admission, and cross-border transfer for advanced care. In February 2026, C. auris was first isolated from a catheter-tip culture and confirmed by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) at the Jordan Center for Disease Control laboratories. The patient subsequently developed sepsis, with C. auris recovered from blood cultures. Whole-genome sequencing identified the isolate as C. auris Clade I harboring the ERG11 Y132F mutation, associated with reduced azole susceptibility. The patient was treated with intravenous anidulafungin for 14 days, with progressive clinical improvement and sustained clearance of candidemia on follow-up cultures. This case illustrates that C. auris should be considered in critically ill patients with prolonged hospitalization, invasive devices, and extensive antimicrobial exposure, particularly in conflict-affected populations navigating fragmented, cross-border care. The case also highlights the value of timely coordination among clinicians, hospital microbiology services, reference laboratories, and infection control teams in supporting early recognition, rapid confirmation, and prompt infection control action.