Candida auris: The recent emergence of a multidrug-resistant fungal pathogen

Abstract

Candida auris is an emerging multidrug-resistant yeast that causes serious invasive infections with high mortality. It was first discovered in 2009, and since then, individual cases or outbreaks have been reported from over 20 countries on five continents. Controlling C. auris is challenging for several reasons: (1) it is resistant to multiple classes of antifungals, (2) it can be misidentified as other yeasts by commonly available identification methods, and (3) because of its ability to colonize patients perhaps indefinitely and persist in the healthcare environment, it can spread between patients in healthcare settings. The transmissibility and high levels of antifungal resistance that are characteristic of C. auris set it apart from most other Candida species. A robust response that involves the laboratory, clinicians, and public health agencies is needed to identify and treat infections and prevent transmission. We review the global emergence, biology, challenges with laboratory identification, drug resistance, clinical manifestations, treatment, risk factors for infection, transmission, and control of C. auris.

New and emerging infectious diseases (Ebola, Middle Eastern respiratory syndrome coronavirus, carbapenem-resistant Enterobacteriaceae, Candida auris): Focus on environmental survival and germicide susceptibility

“…128,130,131 The microbiology, clinical syndromes, diagnosis, and treatment of C auris have been reviewed. 127,[132][133][134][135][136] Genetic analyses have shown that C auris is most closely related to C lusitaniae and C haemulonii, although it has a striking divergence from some other Candida species. 127 C auris is often misidentified in conventional diagnostic laboratories using biochemical typing.…”

“…137 Risk factors for infection have usually included care in an intensive care unit, the presence of indwelling central venous catheters, arterial lines, Foley catheters, invasive surgical procedures, mechanical ventilation, and prior or continued exposure to broad-spectrum antibiotics and antifungal agents. 132,133,136 Mortality rates >30% have been reported for patients with invasive infections. 127,132,133 At the present time, there are no clinical breakpoints for C auris.…”

Antifungal susceptibility of yeast bloodstream isolates collected during a 10‐year period in Austria

“…Also, C. auris , an emerging multidrug‐resistant yeast causing candidemia and invasive infections with high mortality in healthcare settings, poses a global health threat and should not be neglected. In this species, multidrug resistance is common and occasionally isolates are resistant to all three classes of antifungal agents …”

Diagnosis, management and prevention of Candida auris in hospitals: position statement of the Australasian Society for Infectious Diseases

“…auris as another Candida species (Table ), most frequently C . haemulonii . In one study, approximately 90% of isolates reported as C .…”

“…Healthcare outbreaks have been reported from at least eight countries . Some outbreaks from Europe and USA are summarised in Table .…”