Candida auris Infection and Biofilm Formation: Going Beyond the Surface
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MYCOLOGY (R CRAMER, SECTION EDITOR)
Candida auris Infection and Biofilm Formation: Going Beyond the Surface Mark V. Horton 1 & Jeniel E. Nett 1
# The Author(s) 2020
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 . Biofilm . Pathogenicity . Skin . Colonization . Antifungal resistance
Introduction Candida auris was first described in 2009, following the isolation of this new species from the ear canal of a patient in Japan [1]. Since its discovery, we have witnessed numerous outbreaks of C. auris in healthcare centers throughout the world [2]. C. auris represents the first fungal pathogen to be termed a global public health threat, which is based on its ability to spread patient-to-patient and cause invasive disease with high mortality [2–4]. Other obstacles in the treatment of C. auris include its profound resistance to antifungal drugs as well as delays in diagnosis and treatment, as this new pathogen is not present in many clinical diagnostic systems [5, 6]. This article is part of the Topical Collection on Mycology * Jeniel E. Nett [email protected] 1
Departments of Medicine and Medical Microbiology & Immunology, University of Wisconsin-Madison, Madison, WI, USA
The rampant nosocomial transmission observed for C. auris is unique to this species of Candida. Recent investigations are just beginning to shed light on the C. auris traits that may be involved in hospital spread. Like other Candida species, C. auris exhibits the capacity to form biofilms [7••, 8•, 9•, 11••]. Here, we highlight the characteristics of biofilms formed by C. auris and describe how this mode of growth contributes to the ability of C. auris to colonize skin, persist in the hospital environment, resist antimicrobial therapy, and cause invasive disease (Fig. 1).
What Is the Clinical Presentation of C. auris Infection? C. auris infection occurs at a variety of clinical sites, including the bloodstream, wounds, and the urinary tract [6, 12, 13]. In addition, C. auris colonizes skin, nares, wounds, and urine, as a marker of disease risk [3, 6, 14]. Similar to patients with candidiasis caused by other species, patients with invasive
Curr Clin Micro Rpt
Fig. 1 C. auris forms high-density biofilms in skin niche conditions and in hospitalized sett
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