Abstract
Since Candida auris integrates strains resistant to multiple antifungals, research has been conducted focused on knowing which molecular mechanisms are involved. This review aims to summarize the results obtained in some of these studies. A search was carried out by consulting websites and online databases. The analysis indicates that most C. auris strains show higher resistance to fluconazole, followed by amphotericin B, and less resistance to 5-fluorocytosine and caspofungin. In C. auris, antifungal resistance to amphotericin B has been linked to an overexpression of several mutated ERG genes that lead to reduced ergosterol levels; fluconazole resistance is mostly explained by mutations identified in the ERG11 gene, as well as a higher number of copies of this gene and the overexpression of efflux pumps. For 5-fluorocytosine, it is hypothesized that the resistance is due to mutations in the FCY2, FCY1, and FUR1 genes. Resistance to caspofungin has been associated with a mutation in the FKS1 gene. Finally, resistance to each antifungal is closely related to the type of clade to which the strain belongs.
Highlights
Candida auris is characterized for being a critical pathogen worldwide that has resistance to virtually all antifungals commonly used in the treatment of invasive fungal infections
Candida auris is considered a global public health problem due to the increase of multi-resistant strains to different antifungal groups, leaving few therapeutic options currently
The possibility has been raised that the C. auris genome has adapted to emerge as a resistant pathogen due to the indiscriminate use of broad-spectrum antibiotics and antifungals, as it presently occurs with resistance to triazoles, due to their abuse in marginalized populations
Summary
Candida auris is characterized for being a critical pathogen worldwide that has resistance to virtually all antifungals commonly used in the treatment of invasive fungal infections. C. auris poses a severe threat to human health due to the increase in the frequency with which it occurs, mainly in Intensive Care Unit patients, where life-threatening candidiasis outbreaks have occurred. In some countries, this is being considered as a serious public health problem [1,2,3]. Phylogenetic studies carried out in genomes of various C. auris [6,7,8] isolates have identified four predominant populations (clades I, II, III, and IV). The evidence of a smaller population, related to an Antibiotics 2020, 9, 568; doi:10.3390/antibiotics9090568 www.mdpi.com/journal/antibiotics
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