Dr. Sudha Chaturvedi is the Director of the Mycology Laboratory_[1], which serves as the comprehensive reference facility for fungal diagnostics for all NYSDOH-licensed clinical laboratories, including hospitals, academic medical centers, county health departments, and commercial laboratories.

Since 2016, the Mycology Laboratory also serves as an Antibiotic Resistance Lab Network Laboratory for the Centers for Disease Control and Prevention (CDC), assessing the prevalence of drug-resistant Candida spp. in the Northeast.

Some of the laboratory's major undertakings include innovations in fungal diagnostics, antifungal testing, drug-resistance mechanisms, fungal pathogenesis, and molecular epidemiology.

The laboratory utilizes state of the art technologies including: 

• Next-generation sequencing in clinical mycology
• Molecular methods for fungal detection and identification
• Application of protein-based technologies for yeast and mold identification
• The study of the antifungal drug-resistance trends, mechanisms of action, and detection methods
• Analysis of population-level trends of invasive fungal infection 
• Development of vertebrate and invertebrate model systems for fungal pathogens

The Mycology Laboratory collaborates with federal and industry partners to improve the knowledge of fungal infection and well-being in our communities. The laboratory houses a fungal culture collection repository, an outstanding resource for assay development, distribution, and sale. 

Major research accomplishments

Development of the rapid and sensitive molecular assay for the direct detection of multidrug-resistant Candida auris from patient samples
Candida auris, a multidrug-resistant yeast, emerged in the United States in 2016, causing an unprecedented outbreak in several states. The Mycology Laboratory developed a rapid molecular test to directly detect C. auris from patient samples_[2]. The rapid test played a crucial role in combating the C. auris outbreak. The rapid test was subsequently adopted by the CDC, all seven AR Lab Network Laboratories, along with several public health and clinical laboratories in the US. In 2018, the Council of State and Territorial Epidemiologists (CSTE) used our molecular test as the marker for the culture-independent case definition of patients colonized with C. auris. We transitioned the test from a manual to a high-throughput BD MAX platform_[3]. The rapid test is now included in the CDC’s proficiency testing program for all seven regional labs, with 100% accuracy, a testament to consistency across the board. Collaborations are also underway to bring about a point-of-care testing device_[4] to be used at the patient’s bedside or physician’s office.

Detection of pan-resistant isolates of Candida auris from New York
The Mycology Laboratory aided NYS epidemiologists in characterizing pan-resistant isolates of C. auris from three NY patients. This is the first report of the identification of pan-resistant strains of C. auris from the US. The active surveillance following identification led to no further spread _[5]of these strains in the affected healthcare facilities.

C. auris outbreak: Impact and Lessons Learned
The efforts of the Mycology Laboratory in assay development, resistance detection, genotyping, use of combined swab of nares/axilla/groin, quantification of C. auris from patient skin and healthcare environment demonstrating extensive colonization of biotic (patient) and abiotic (healthcare objects) surfaces resulted in publication_[6], which was later recognized as worthy of an accompanying commentary_[7]. APHL featured our exemplary work on C. auris in the 2019 summer issue of Lab Matters_[8].