Candida auris: Epidemiology, biology, antifungal resistance, and virulence

Abstract

First described in 2009 in Japan, the emerging multidrug-resistant fungal pathogen Candida auris is becoming a worldwide public health threat that has been attracting considerable attention due to its rapid and widespread emergence over the past decade. The reasons behind the recent emergence of this fungus remain a mystery to date. Genetic analyses indicate that this fungal pathogen emerged simultaneously in several different continents, where 5 genetically distinct clades of C . auris were isolated from distinct geographical locations. Although C . auris belongs to the CTG clade (its constituent species translate the CTG codon as serine instead of leucine, as in the standard code), C . auris is a haploid fungal species that is more closely related to the haploid and often multidrug-resistant species Candida haemulonii and Candida lusitaniae and is distantly related to the diploid and clinically common fungal pathogens Candida albicans and Candida tropicalis . Infections and outbreaks caused by C . auris in hospitals settings have been rising over the past several years. Difficulty in its identification, multidrug resistance properties, evolution of virulence factors, associated high mortality rates in patients, and long-term survival on surfaces in the environment make C . auris particularly problematic in clinical settings. Here, we review progress made over the past decade on the biological and clinical aspects of C . auris . Future efforts should be directed toward understanding the mechanistic details of its biology, epidemiology, antifungal resistance, and pathogenesis with a goal of developing novel tools and methods for the prevention, diagnosis, and treatment of C . auris infections.

In Vitro Synergistic Interactions of Isavuconazole and Echinocandins against Candida auris

“…Additionally, C. auris is able to form biofilms on the skin, on implanted medical devices or in the hospital environment [ 17 ]. As these biofilms are even more resistant to antifungal agents compared to planktonic cells [ 17 , 18 ], the possible benefits of the aforementioned synergy should also be assessed in fighting such a biofilm community.…”

Candida auris: Epidemiology, Diagnosis, Pathogenesis, Antifungal Susceptibility, and Infection Control Measures to Combat the Spread of Infections in Healthcare Facilities

“…Studies describing single/multiple invasive infections and outbreaks in different countries or geographical locations in the last several years have been extensively reviewed, only some of which are cited here [ 29 , 30 , 31 , 32 , 38 ]. For a comprehensive listing and chronological order of countries reporting C. auris cases between January 2009 and June 2020 and all major outbreaks, readers are directed to two recently published excellent reviews [ 62 , 63 ]. The number of patients affected and the mortality rates in some selected outbreaks reported recently from January 2019 to January 2021 are shown in Table 1 .…”

Characteristics, Risk Factors, and Survival Analysis of Candida auris Cases: Results of One-Year National Surveillance Data from Oman

“…Since then, it has spread to all continents but Antarctica [ 1 , 2 ]. It is increasingly described as an agent of hospital-acquired infections and has gained global attention due to its multidrug-resistant properties and high crude mortality rate, up to 40% in cases of bloodstream infections [ 2 , 3 , 4 , 5 ]. In addition, C. auris strains are difficult to identify and can be misidentified as other phylogenetically related pathogens [ 6 ].…”