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Published on: March 19, 2019
Pathogenicity and virulence of Candida auris
Trinh Phan-Canh1,2,3, Saskia Seiser3, Manju Chauhan4
1Max Perutz Labs Vienna, Vienna Biocenter Campus (VBC), Vienna, Austria.
Abstract:
Candida auris (Candidozyma auris) has emerged as a multidrug‑resistant human fungal pathogen that causes infections of high morbidity and mortality. Notably, it exhibits a unique ability to grow and persist on human skin, thus leading to efficient transmission through skin-to-skin contact. As a result, C. auris poses a significant risk of outbreaks in healthcare settings, especially in nursing homes that care for elderly patients. Most concerning, C. auris clinical isolates demonstrate widespread and, in some cases, untreatable resistance to all antifungal drug classes, including azoles, polyenes (amphotericin B), and echinocandins. Consequently, invasive C. auris infections cause high mortality rates (30-60%) even with antifungal therapy. Here, we provide a comprehensive overview of candidiasis caused by C. auris, discussing both host and pathogen determinants of skin colonization, as well as key challenges associated with preventing dissemination and management of disseminated fungal infections.
Insights
Candida auris is a dangerous, drug-resistant fungus spreading through skin contact, causing severe infections. New strategies are urgently needed to combat its spread and treat difficult-to-manage candidiasis.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Candida auris is a multidrug-resistant fungal pathogen causing high morbidity and mortality.
- It efficiently transmits via skin-to-skin contact, posing risks in healthcare settings, particularly nursing homes.
- Clinical isolates show resistance to all major antifungal drug classes, leading to high mortality rates (30-60%) even with treatment.
Purpose of the Study:
- To provide a comprehensive overview of Candida auris candidiasis.
- To discuss host and pathogen factors in skin colonization.
- To highlight challenges in preventing dissemination and managing infections.
Main Methods:
- Literature review and synthesis of current research on Candida auris.
- Analysis of epidemiological data and clinical case studies.
- Examination of antifungal resistance mechanisms and treatment outcomes.
Main Results:
- Candida auris demonstrates significant antifungal resistance, including to echinocandins, azoles, and amphotericin B.
- Skin colonization is a key factor in its persistence and transmission.
- Invasive infections result in high mortality, underscoring treatment challenges.
Conclusions:
- Effective prevention of Candida auris dissemination in healthcare settings is critical.
- Management of invasive candidiasis requires addressing widespread drug resistance.
- Further research into host-pathogen interactions and novel therapeutic strategies is essential.
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