The global spread of the fungal species Candida auris poses increasing challenges, with new insights into its virulence emerging from a recent review by scientists at Hackensack Meridian Center for Discovery and Innovation (CDI). This comprehensive study emphasizes that while C. auris presents significant threats, there are strategic measures in development aimed at combating this invasive and drug-resistant pathogen.
Co-authored by Neeraj Chauhan, Ph.D., and Anuradha Chowdhary, Ph.D., a recognized authority on fungal infections, the paper published in Microbiology and Molecular Biology Reviews highlights the alarming statistics associated with invasive fungal infections, which affect around 6.5 million individuals each year and carry high mortality rates. Dr. Chowdhary was instrumental in identifying C. auris as a public health concern in India in 2014, underscoring the growing international focus on this pathogen.
C. auris, first identified in 2009 from an ear sample of a patient in Japan, has been rapidly spreading. Researchers theorize that climate change may play a role in its emergence and proliferation. Notably, the cell wall of C. auris features a unique sugar-dense composition, contributing to its drug resistance and enhancing its interaction with hosts.
The fungus exhibits remarkable survival mechanisms, such as morphogenesis, allowing it to switch between yeast and filamentous growth, form multicellular aggregates, and alter its genetic expression in response to environmental changes. Additionally, its ability to readily colonize human skin, aided by cell wall proteins that adhere firmly to mammalian cells and surfaces, poses significant challenges for treatment.
Despite the host’s immune response to combat C. auris, evidence suggests that the fungus can employ strategies to evade these defenses. However, prospects for new vaccinations and treatment approaches are promising. Currently, four classes of antifungal drugs are available, along with three new treatments under trial that are expected to enhance therapeutic options soon.
Diagnostic challenges persist, as conventional laboratory tests often misidentify C. auris as other related fungi, delaying effective treatment. Nevertheless, growing awareness about this emerging health threat is facilitating increased research to meet clinical needs.
The review advocates for the development of novel antifungal agents with broad-spectrum efficacy, improved diagnostic tests, and innovative immune- or vaccine-based treatment modalities for vulnerable patient populations. Efforts to enhance awareness and surveillance of fungal diseases, particularly in under-resourced regions, are also essential to improve outcomes for those affected by opportunistic fungal infections. The proactive research agenda aims to safeguard public health as the medical community adapts to these complex fungal threats.