Candida auris: Epidemiology, biology, antifungal resistance, and virulence.

First described in 2009 in Japan, the emerging multidrug-resistant fungal pathogenCandida aurisis becoming a worldwide public health threat that has been attracting considerable attention due to its rapid and widespread emergence over the past decade. The reasons behind the recent emergence of this fungus remain a mystery to date. Genetic analyses indicate that this fungal pathogen emerged simultaneously in several different continents, where 5 genetically distinct clades ofC.auriswere isolated from distinct geographical locations. AlthoughC.aurisbelongs to the CTG clade (its constituent species translate the CTG codon as serine instead of leucine, as in the standard code),C.aurisis a haploid fungal species that is more closely related to the haploid and often multidrug-resistant speciesCandida haemuloniiandCandida lusitaniaeand is distantly related to the diploid and clinically common fungal pathogensCandida albicansandCandida tropicalis. Infections and outbreaks caused byC.aurisin hospitals settings have been rising over the past several years. Difficulty in its identification, multidrug resistance properties, evolution of virulence factors, associated high mortality rates in patients, and long-term survival on surfaces in the environment makeC.aurisparticularly problematic in clinical settings. Here, we review progress made over the past decade on the biological and clinical aspects ofC.auris. Future efforts should be directed toward understanding the mechanistic details of its biology, epidemiology, antifungal resistance, and pathogenesis with a goal of developing novel tools and methods for the prevention, diagnosis, and treatment ofC.aurisinfections.