The urgent and challenging superbug fungus Candidozyma auris (formerly Candida auris): a comprehensive review

Based on recent literature, this review critically summarises current information on Candidozyma auris (formerly known as Candida auris) infections to identify factors contributing to their emergence and persistence in healthcare settings. Specifically, it seeks to identify major gaps and challenges in Candidozyma auris (C. auris) classification, diagnostic methods, virulence traits, antifungal therapy, and infection prevention, thereby providing a consolidated evidence base to support improved clinical management, surveillance, and future research. Recent advances have enabled rapid, accurate identification of C. auris using updated MALDI-TOF MS databases and real-time PCR assays. Novel antifungal agents and combination therapies offer potential options against resistant and biofilm-forming C. auris, while recent studies of aggregation, biofilm formation and adhesion, and phenotypic switching have provided new insights into its virulence and persistence in healthcare settings. C. auris exhibits many virulence traits that influence the severity of its infections. Identifying C. auris using conventional microbiological and culture-based methods can be challenging, often leading to delayed diagnoses and inappropriate treatment of infections. Its resistance to commonly used antifungal drugs, including azoles, polyenes and echinocandins, further complicates infection control and treatment strategies. C. auris strains are classified into six distinct clades: South Asia, East Asia, South Africa, South America, Iran and Singapore. Each clade exhibits unique genetic characteristics and varying levels of drug resistance. The emergence of C. auris underscores the high priority and urgent need for research, the development of practical molecular-based diagnostic tools, novel antifungal therapies, and robust infection control measures to combat this growing threat.