Candida auris : host interactions, antifungal drug resistance, and diagnostics

SUMMARY Invasive fungal infections affect approximately 6.5 million people every year. These infections are frequently associated with high mortality rates, often exceeding 50%, even with antifungal therapy. Candida auris is a multidrug-resistant fungal pathogen that has a unique ability to grow and persist on human skin. Long-term skin colonization by C. auris is a significant medical concern because colonized patients may facilitate inter- and intra-hospital transmission of C. auris to other patients. Furthermore, C. auris -colonized patients are at risk of developing more serious systemic infections. The diagnosis of C. auris infections is often hampered by misidentification, leading to delays in starting appropriate antifungal therapy. Here, we summarize the global burden of candidiasis due to C. auris , antifungal drug resistance mechanisms, host and fungal factors affecting skin colonization, current diagnostic approaches, as well as current and future challenges to combat the spread of invasive fungal infections.