New Insights into the Global Expansion of Candida auris: A Growing Threat to Global Health
The fungal species Candida auris is rapidly spreading across the globe and becoming more virulent, according to a recent review by scientists from the Hackensack Meridian Center for Discovery and Innovation (CDI). However, there are strategies in place to combat this invasive and drug-resistant germ, according to the review published in the American Society of Microbiology journal, Microbiology and Molecular Biology Reviews.
The paper summarizes and analyzes the latest developments and needs in mycology in 2025. The co-authors are Neeraj Chauhan, Ph.D., of the CDI, Anuradha Chowdhary, Ph.D., a global leader in identifying and combating fungal threats and one of the first scientists to identify C. auris as a major public health threat in India in 2014, and Michail Lionakis, M.D., Sc.D., a physician-scientist and one of the foremost fungal immunologists globally.
Their findings reveal:
Invasive fungal infections affect approximately 6.5 million people annually, with high mortality rates.
C. auris was first identified as a distinct species in 2009 in a patient's ear in Japan and has been spreading ever since.
Climate change is often cited as a contributing factor to the emergence and spread of C. auris.
The cell wall of C. auris has a unique adaptation compared to other fungi, with a sugar-dense structure that provides advantages in drug resistance and host interactions.
C. auris has developed sophisticated cellular strategies for survival, including the ability to switch from yeast growth to filament-driven spread, form multicellular aggregates, and adjust its phenotypic genetic expression in response to its environment.
The fungus is highly successful in colonizing human skin, with molecular evidence showing that its cell wall proteins attach to mammalian cells and even non-living surfaces like glue.
While the host develops mechanisms to fight C. auris, the germ can proactively evade the immune response. However, new vaccination and treatment strategies are possible.
Four classes of antifungal drugs are currently available, but their efficacy varies since they were developed in the latter half of the 20th century.
Three new drugs are in trials or recently approved and expected to be available for treatment soon.
Diagnostics remain challenging, as most conventional lab tests misidentify C. auris as other related yeasts, delaying and complicating treatment.
Awareness of the burden of this relatively new scourge is increasing, and research is expanding to meet clinical needs.
The authors emphasize the need for novel antifungal agents with broad-spectrum activity against human fungal pathogens, improved diagnostic tests, and immune- and vaccine-based adjunct modalities for high-risk patients. They also call for raising awareness about fungal disease through better surveillance mechanisms, especially in resource-poor countries.
These developments, they conclude, should help improve the outcomes and prognosis of patients affected by opportunistic fungal infections.
Source: Chowdhury, A., et al. (2025). Candida auris: Host Interactions, Antifungal Drug Resistance, and Diagnostics. Microbiology and Molecular Biology Reviews. doi: 10.1128/mmbr.00187-22. https://journals.asm.org/doi/10.1128/mmbr.00187-22
