Candida auris – susceptibility to antifungals and treatment recommendations

Abstract

Yeast-like fungi of the genus <i>Candida</i>, most often <i>C. albicans</i>, are usually a part of the physiological microflora of humans, however in immunocompromised individuals may cause invasive infections. At present species other than <i>C. albicans</i> are increasingly reported, but therapy of these infections is difficult because these fungi are more resistant to antifungals. <i>Candida auris</i> is a newly described species of yeast-like fungi of the genus <i>Candida</i>, causing infections in hospitalised patients – predominantly fungaemias, sometimes with severe course. This form of infection is linked to a high mortality of patients – from 30 to 72%. This species has also the ability of epidemic spread in healthcare facilities. Treatment of infections caused by C. auris poses a therapeutic challenge, as almost all strains of this species are resistant to fluconazole. It may also be linked to cross-resistance to other azoles. Importantly, many isolates of <i>C. auris</i> are resistant to amphotericin B, and strains resistant to echinocandins (which are at present recommended as first line therapy of these infections) have also been described. Currently there are no recommendations as to the combined therapy of infections of this etiology. New antifungal agents potentially active against <i>C. auris</i> are under development.