Candida auris skin colonization: mechanisms, microecological interactions, and emerging decolonization strategies

Candida auris, as an emerging multidrug-resistant pathogen, has become a major threat to global public health due to its high mortality rate, strong transmissibility, and propensity to cause outbreaks in healthcare settings. Persistent skin colonization is a key factor contributing to the high transmissibility of C. auris and represents one of its important distinguishing features from other Candida species. However, the mechanisms underlying C. auris skin colonization remain poorly understood, and relevant prevention and control strategies are still underdeveloped. This article aims to systematically review the epidemiological characteristics of C. auris skin colonization, alterations in the skin microbiota, host immunoregulatory mechanisms, colonization mechanisms, and decolonization strategies, thereby providing a theoretical basis for further understanding the pathogenic mechanisms of C. auris, optimizing infection prevention and control measures, and developing targeted decolonization intervention strategies.