Mycology: Candida auris: practice question

A Microbiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Microbiology · Mycology: Candida auris

Sample item

In an ICU outbreak, several patients with central lines develop candidaemia. The yeast is identified as Candida haemulonii by a biochemical system, is resistant to fluconazole, and is cultured from bed rails and skin swabs. Which treatment is most appropriate initially?

AAn echinocandin such as micafunginBOral nystatin suspensionCFluconazole at a higher doseDOral flucytosine alone

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. An echinocandin such as micafungin

Candida auris is often misidentified as C. haemulonii by older phenotypic systems, and is accurately identified by MALDI-TOF or sequencing. It is frequently multidrug resistant, colonises skin and persists on surfaces, so outbreaks need contact precautions and environmental cleaning. An echinocandin is recommended first-line therapy.

Option by option

A. An echinocandin such as micafungin (correct)
Correct. Echinocandins are the recommended initial therapy for C. auris candidaemia.
B. Oral nystatin suspension
Nystatin is not absorbed and has no role in bloodstream infection.
C. Fluconazole at a higher dose
Most C. auris isolates are resistant to fluconazole, so a higher dose is not a reliable fix.
D. Oral flucytosine alone
Flucytosine alone allows rapid emergence of resistance and is used only in combination.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Microbiology question

What is the answer to this Microbiology question?

The best answer is A, An echinocandin such as micafungin. Candida auris is often misidentified as C.

Why is "Oral nystatin suspension" not the answer?

Nystatin is not absorbed and has no role in bloodstream infection.

Why is "Fluconazole at a higher dose" not the answer?

Most C. auris isolates are resistant to fluconazole, so a higher dose is not a reliable fix.

Why is "Oral flucytosine alone" not the answer?

Flucytosine alone allows rapid emergence of resistance and is used only in combination.

What concept does this question test?

It tests Mycology: Candida auris in Microbiology. haemulonii by older phenotypic systems, and is accurately identified by MALDI-TOF or sequencing. It is frequently multidrug resistant, colonises skin and persists on surfaces, so outbreaks need contact precautions and environmental cleaning. An echinocandin is recommended first-line therapy.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Mycology: Candida auris?

Make a one-line identity card for each organism: shape and stain, defining test, toxin, disease and drug. Then use the flashcards and the other Microbiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.