Candida auris and mechanisms of antifungal drug resistance

Abstract

Candida auris has been isolated from clinical samples in different regions and countries since it was first described in 2009. Due to the difficulties in identification; decreased susceptibility or resistance to antifungal agents; exceptional capacity to colonize and persist on surfaces; ability to survive despite standard disinfection procedures; and significant increase in the number of regions and countries with reported cases, C.auris has become a global health concern and placed among the World's ten most concerned fungi list in 2018. It is stated that 60-90% of C.auris strains are resistant to fluconazole, 10- 30% exhibit high minimum inhibitory concentration values for amphotericin B, and up to 5% can be considered as resistant to echinocandins. Existing data obtained from ongoing research on molecular mechanisms of antifungal resistance in C.auris revealed some common features with other Candida species. However, diverging aspects are also reported. In this review article, current information on molecular mechanisms and biofilm-related factors responsible for decreased susceptibility or resistance to antifungal agents and unexpectedly high survival potential of C.auris have been discussed.