Emergence of Candida (Candidozyma) auris in Warming Climates

Candida (Candidozyma) auris is a pathogenic fungus first identified in a patient in 2009. Prior to this clinical finding, C. auris was unknown, with its closest relative being the marine-dwelling Candida haemulonii. Infections are increasing annually, predominately impacting hospital patients due to durable biofilms on medical devices and antimicrobial resistance. Perplexingly, the fungus arose nearly simultaneously across the globe in independent disease emergences from six genetically distinct clades. The C. auris clades mostly diverged from one another 5,000-10,000 years ago, during a period when global temperatures and sea levels rose and coastal wetlands flourished. Within the past 200-300 years, a new wave of rapid divergence occurred within each clade. This corresponds to industrialization, urbanization, global warming, and the widespread wetland destruction. Environmental stressors, including heat, are hypothesized to have driven mutations and stress resistance. These may not only help C. auris withstand a changing climate but also help it thrive within mammalian hosts.