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Genomic Insights of Candida krusei, an Emerging Fungal Pathogen With Intrinsic Antifungal Resistance
Kusum Jain1, Khushbu Wadhwa1, Meenakshi Malik1
1Fungal Biology Laboratory, Department of Zoology, Ramjas College, University of Delhi, Delhi, India.
Abstract:
Candida krusei is diploid, dimorphic, opportunistic yeast belonging to the methylotrophic clade, known for causing infections primarily in immunocompromised individuals. It is globally distributed with variable prevalence across regions and patient populations. C krusei has been associated with several nosocomial outbreaks, particularly in neonatal intensive care units. A key concern is its intrinsic resistance to fluconazole, often resulting in high mortality. The mechanisms of azole resistance are complex and include low affinity of the Erg11p enzyme, overexpression of efflux pumps, and mutations in the ABC11 gene. Additionally, echinocandin resistance has emerged due to mutations in the hotspot regions of the FKS1 gene. Its biofilm-forming ability further enhances its survival against antifungal agents and immune responses. This study highlights C krusei as a clinically significant and emerging fungal pathogen, emphasizing the need for enhanced surveillance, molecular monitoring, and continued research to mitigate its growing threat in healthcare settings.
Insights
Candida krusei, an opportunistic yeast, causes infections in immunocompromised patients and exhibits resistance to antifungal drugs. Enhanced surveillance and research are crucial to combat this emerging fungal threat.
Area of Science:
- Mycology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Candida krusei is a diploid, dimorphic, opportunistic yeast.
- It is a globally distributed pathogen causing infections primarily in immunocompromised individuals.
- C. krusei is associated with nosocomial outbreaks, especially in neonatal intensive care units.
Purpose of the Study:
- To highlight Candida krusei as a clinically significant emerging fungal pathogen.
- To emphasize the need for enhanced surveillance and molecular monitoring.
- To underscore the necessity for continued research to mitigate its growing threat.
Main Methods:
- This study is a review of existing literature on Candida krusei.
- It synthesizes information on prevalence, resistance mechanisms, and clinical significance.
- Focuses on molecular mechanisms of antifungal resistance.
Main Results:
- Candida krusei exhibits intrinsic resistance to fluconazole due to enzyme affinity, efflux pumps, and ABC11 gene mutations.
- Emergence of echinocandin resistance is linked to FKS1 gene mutations.
- Biofilm formation contributes to C. krusei's survival against antifungals and immune responses.
Conclusions:
- Candida krusei poses a significant and growing threat in healthcare settings.
- Its intrinsic and emerging resistance mechanisms necessitate targeted therapeutic strategies.
- Enhanced surveillance, molecular monitoring, and ongoing research are vital for effective management.
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