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Candida auris: a multidimensional focus on its identification, epidemiology, pathogenesis, and therapeutic options
Humans have encountered many epidemics caused by pathogenic microorganisms since the turn of the century. The prevalence of fungal infections has significantly increased on a global scale, adversely impacting human health. Candida species remain among the most prevalent and widely spread opportunistic fungi, with Candida auris emerging as a notorious hospital-acquired pathogen. This fungal pathogen causes nosocomial bloodstream infections (BSI), coupled with a high in-hospital death rate and significant multidrug-resistance (MDR). Standard quaternary ammonium compounds (Quats), are often ineffective, requiring the use of Environmental Protection Agency (EPA)-registered hospital-grade disinfectants. Routine laboratory procedures often fail to efficiently identify the fungi, making it difficult to predict the infection's true severity. Hence, molecular-based methods are now considered the gold standard for rapid identification. Despite the availability of approved drugs, their efficacy is questionable due to the emerging drug resistance within the fungal population. The organism appears to acquire drug resistance quickly. While echinocandins remain first-line therapy, the emergence of echinocandin-or pan-resistant cases indicates that treating pan-resistant strains would be particularly tricky, if not unfeasible. This underscores the urgent need for enhanced infection control, improved point-of-care diagnostics, and the development of novel therapeutic strategies. This article highlights the crucial aspects of epidemiology, identification techniques, drug resistance mechanisms, treatments, and challenges associated with C. auris infections. Understanding these interconnected aspects is essential for optimizing clinical management and mitigating the escalating public health crisis posed by this tenacious pathogen.
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