Tackling a global threat: a clinical scenario-based framework for preventing and managing Candidozyma auris...

Candidozyma auris (formerly Candida auris) has emerged as a formidable global health threat, characterized by its multidrug resistance (MDR), high transmissibility in healthcare settings, and significant mortality. The World Health Organization classifies it as a 'critical priority' fungal pathogen. Conventional infection control paradigms, often applying a 'one-size-fits-all' approach, have struggled to contain C. auris due to its unique environmental resilience and transmission dynamics. This review departs from traditional linear analyses and proposes a novel, scenario-based framework to deconstruct the complex challenges of C. auris management. We dissect the distinct transmission dynamics and control vulnerabilities across four high-risk clinical scenarios: the intensive care unit (ICU), long-term care facility (LTCF), high-risk surgical ward, and outpatient settings. Building on this analysis, we introduce the 'C. auris Integrated Control Bundle,' a multi-layered, adaptable toolkit combining patient-level, facility-level, and system-level interventions. This framework provides clinicians and infection preventionists with a practical, evidence-based paradigm to design and implement setting-specific, resource-optimized strategies against this resilient pathogen. We also review current diagnostic and therapeutic challenges, emphasizing the urgent need for rapid diagnostics and novel treatment options. By addressing key unanswered questions, this review aims to guide future research and strengthen the global response to C. auris.