Candida auris infection and biofilm formation: going beyond the surface

Abstract

Purpose of review: Emergent fungal pathogen C. auris is spreading in hospitals throughout the world and mortality rates for patients with invasive disease approach 60%. This species exhibits a heightened capacity to colonize skin, persist on hospital surfaces, rapidly disseminate in healthcare settings, and resist antifungal therapy.

Recent findings: Current investigations show that C. auris produces biofilms, surface-adherent communities that resist antifungals and withstand desiccation. These biofilms form when C. auris is growing on skin or in conditions expected in the hospital environment and on implanted medical devices.

Summary: Here we will highlight the topic of biofilm formation by C. auris. We illustrate how this process influences resistance to antimicrobials and promotes nosocomial transmission.

Keywords: Candida auris; antifungal resistance; biofilm; colonization; pathogenicity; skin.

Fig. 1. C. auris forms high-density biofilms in skin niche conditions and in hospitalized settings.

Scanning electron microscopy shows C. auris growing as a biofilm on porcine skin ex vivo. Dense biofilm formation likely contributes to C. auris pathogenicity and spread in healthcare settings.