Abstract

Candida auris has unprecedently emerged as a multidrug resistant fungal pathogen, considered a serious global threat due to its potential to cause nosocomial outbreaks and deep-seated infections with staggering transmissibility and mortality, that has put health authorities and institutions worldwide in check for more than a decade now. Due to its unique features not observed in other yeasts, it has been categorised as an urgent threat by the Centers for Disease Control and Prevention and other international agencies. Moreover, epidemiological alerts have been released in view of the increase of healthcare-associated C. auris outbreaks in the context of the COVID-19 pandemic. This review summarises the current evidence on C. auris since its first description, from virulence to treatment and outbreak control, and highlights the knowledge gaps and future directions for research efforts.

Highlights

  • The genus Candida is composed of approximately of 200 species

  • In a previous study undertaken by our group, we developed and validated a predictive model of candidaemia in critically ill colonised patients through a prospective approach, creating an equation that could help to predict the estimated risk of candidaemia, dependent on the present risk factors [151]

  • C. auris has unprecedently emerged as a multidrug resistant pathogen, with an alarming increase in the incidence of nosocomial outbreaks with staggering mortality and transmission rates, that has put health authorities and institutions worldwide in check for more than a decade

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Summary

Introduction

The genus Candida is composed of approximately of 200 species. It is the most important fungal genus in the medical field [1], as some Candida species are the main cause of worldwide invasive fungal infections (IFI) [2,3]. C. auris is an emergent species which, as a consequence of its multidrug resistance to common antifungals [10,11,12], difficult identification with conventional biochemical microbiological techniques [13,14], high transmissibility, surface survival [15], and environmental adaptability [16,17], has been associated with serious nosocomial IFI with high mortality and is extremely difficult control in many countries [11,16,18,19,20]. C. auris in tropical remote beaches of the Andaman Islands (India) [48] confirms for the first time the presence of an environmental niche and supports the global warming hypothesis in the emergence of C. auris

Phylogeny
Virulence
Virulence Results
Antifungal Resistance
Persistence in the Healthcare Environment
Colonization
Infection
Conclusions
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