What Do We Know about Candida auris? State of the Art, Knowledge Gaps, and Future Directions

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.

Keywords: Candida auris; antifungal agents; candidaemia; diagnosis; epidemiology; outbreak; pathogenesis; virulence.

Figure 1

Main misidentified species of different commercial biochemical systems. Misidentification of C. auris by means of the VITEK systems has specially been reported with isolates of the east Asian and African clades.

Figure 2

Schema representing the most common colonisation, invasive infection sites, and risk factors for deep-seated infections in patients colonised by C. auris.