Genomic Dynamics of the Emergent Candida auris: Exploring Climate-dependent Trends

Candidozyma auris (formerly known as Candida auris) (C auris) is a multidrug-resistant fungal pathogen that has emerged as a significant threat to global health. Shifts in climatic conditions may be driving its adaptation and pathogenicity. Its increased ability to tolerate higher temperatures has been suggested as the first adaptation led by anthropogenic climate change in a pathogenic organism. In this study, we analyzed 801 whole-genome sequences isolated in clinical settings from the New York-New Jersey region from 2016 to 2024. Using Bayesian hierarchical logistic regression models, we identified previously described antifungal resistance genes, their associated point mutations, heat tolerance genes, and their link with key climatic variables using mixed-effects logistic regression models. Our analysis revealed that the heat tolerance genes HSP90 and HSP104 were present in >98% of isolates. Among the antifungal resistance-related genes, several showed significant associations with climatic variables, particularly with precipitation and temperature. Elevated precipitation was consistently linked to increased prevalence in antifungal resistance genes and their associated point mutations, suggesting that elevated moisture levels may promote favorable conditions for fungal growth and biofilm formation. Additionally, the interaction between climatic variables showed a stronger association with the presence of resistance genes, evidencing the multifactorial nature of climate change in shaping pathogen adaptations. These findings emphasize the influence of climatic variables on the resistome of C auris, which is crucial for predicting the spread and resistance patterns of C auris as climate change continues.