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Candida auris is emerging as a prevalent urinary pathogen
Alyssa Ann La Bella1, Felipe Hiram Santiago-Tirado1, Ana Lidia Flores-Mireles1
1Department of Biological Sciences, University of Notre Dame, Notre Dame, Indiana, United States of America.
Abstract:
Urinary tract infections (UTIs) are one of the most common infections, with a subgroup of these infections, catheter-associated UTIs (CAUTIs), accounting for 40% of nosocomial infections. While the majority of CAUTI pathogens are bacterial, the second most common pathogen is the fungus Candida albicans. However, in recent years, Candida auris has increasingly been isolated from urine, indicating C. auris' potential as a urinary pathogen. C. auris has rapidly emerged as a human pathogen worldwide, becoming a serious health threat. This is of great concern due to its antifungal resistance, adherence to inanimate surfaces, high mortality rates, and the extensive knowledge gap regarding C. auris' prevalence and pathophysiology. To understand whether C. auris is prevalent in the urinary tract, we analyzed 12,996 C. auris clinical strains and their frequency related to urine and urinary catheters. We identified urine as the second most common C. auris isolation source in the United States and the third most common worldwide. Anecdotally, C. auris urine isolates are often associated with urinary catheters and high mortality rates. Furthermore, there has been an early indication of urinary isolates developing echinocandin resistance. With the increasing incidence of uropathogenic C. auris, it is critical to have an in-depth understanding of C. auris pathogenesis in the urinary tract to effectively prevent and treat these infections.
Insights
Candida auris is emerging as a significant urinary pathogen, frequently linked to catheters. Understanding its prevalence and resistance is crucial for treating these serious infections.
Area of Science:
- Infectious Diseases
- Mycology
- Urology
Background:
- Catheter-associated urinary tract infections (CAUTIs) are a major healthcare concern, predominantly caused by bacteria.
- Candida auris, a fungus, is increasingly identified as a urinary pathogen, posing a growing threat due to its resistance and high mortality.
- Significant knowledge gaps exist regarding the prevalence and pathogenesis of Candida auris in urinary tract infections.
Purpose of the Study:
- To investigate the prevalence of Candida auris in urine samples.
- To analyze the association of Candida auris urine isolates with urinary catheters.
- To assess the clinical significance and resistance patterns of Candida auris in urinary tract infections.
Main Methods:
- Analysis of 12,996 clinical strains of Candida auris.
- Examination of isolation sources, focusing on urine and urinary catheters.
- Review of anecdotal data on mortality rates and antifungal resistance.
Main Results:
- Urine is the second most common source of Candida auris isolation in the United States and third globally.
- Candida auris urine isolates are frequently associated with urinary catheters.
- Early evidence suggests the development of echinocandin resistance in urinary Candida auris isolates, alongside high mortality rates.
Conclusions:
- Candida auris is a significant and increasing cause of urinary tract infections.
- Urinary tract infections caused by Candida auris are associated with urinary catheters and poor outcomes.
- Further research into Candida auris urinary tract infection pathogenesis and resistance is essential for effective management.
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