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Intra-clade Heterogeneity in Candida auris: Risk of Management

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Abstract

Candida auris has emerged as a significant nosocomial fungal pathogen with a high risk of pathogenicity. Since the initial detection of C. auris in 2009, it gained lots of attention with a recent alert by the Centers for Disease Control and Prevention (CDC) due to its high infectivity and drug resistance. Several studies showed the capability of C. auris to secrete lytic enzymes, germinate, and form a biofilm that eventually results in interactions with the host cells, leading to serious infections. Other studies demonstrated a decrease in susceptibility of C. auris strains to available antifungals, which may be caused by mutations within the target genes, or the drug efflux pumps. However, the contribution of C. auris heterogeneity in pathogenicity and drug resistance is not well studied. Here, we shed light on the factors contributing to the development of heterogeneity in C. auris. These include phenotypic changes, biofilm formation, mechanisms of drug resistance, host invasion, mode of transmission, and expression of virulence factors. C. auris exhibits different phenotypes, particularly aggregative, and non-aggregative forms that play an important role in fungal heterogeneity, which significantly affects drug resistance and pathogenicity. Collectively, heterogeneity in C. auris significantly contributes to ineffective treatment, which in turn affects the fungal pathogenicity and drug resistance. Therefore, understanding the underlying reasons for C. auris heterogeneity and applying effective antifungal stewardship could play a major role in controlling this pathogen.

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Abbreviations

ABC:

ATP-binding cassette

AMB:

Amphotericin B

C. auris :

Candida auris

CDC:

Centers for Disease Control and Prevention

CNV:

Copy number variations

DE:

Differential expression

FC:

Filamentation competent

GPI:

Glycosylphosphatidylinositol

GWT1:

GP1-anchored wall transfer protein 1

HSP90:

Heat shock protein

H2O2 :

Hydrogen peroxide

L-AmB:

Liposomal amphotericin B

LD:

Lanosterol demethylase

MDR:

Multidrug resistant

MFS:

Major facilitator superfamily

MIC:

Minimum inhibitory concentration

NaOCL:

Sodium hypochlorite

PBMC:

Peripheral blood monocellular cells

PLAs:

Phospholipases

Pz :

Precipitated zone values

RA:

Replicative aging

SAPK:

Stress-activated protein kinase

SAPs:

Secreted aspartyl proteases

SNPs:

Single-nucleotide polymorphisms

WGS:

Whole-genome sequences

YNB:

Yeast nitrogen Base

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Funding

The authors acknowledge the generous support from CSRG-2021/01 to SSMS and AS and partial funding from the University of Sharjah (Grant# 2101090286).

Author information

Authors and Affiliations

  1. Research Institute for Medical and Health Sciences, University of Sharjah, P.O. Box 27272, Sharjah, UAE

    Bahgat Fayed, Imene K. Lazreg, Razan B. AlHumaidi & Sameh S. M. Soliman

  2. Chemistry of Natural and Microbial Products, National Research Centre, Cairo, Egypt

    Bahgat Fayed

  3. Department of Medicinal Chemistry, College of Pharmacy, University of Sharjah, P.O. Box 27272, Sharjah, UAE

    Razan B. AlHumaidi, Maryam A. A. A. Qasem, Bashayir M. Gh. N. Alajmy, Fatemh M. A. M. Bojbarah & Sameh S. M. Soliman

  4. College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Building 14 Dubai Healthcare City, P.O.Box 505055, Dubai, UAE

    Abiola Senok

  5. Faculty of Pharmacy, Zagazig University, Zagazig, Egypt

    Mohamed I. Husseiny

  6. Department of Translational Research & Cellular Therapeutics, Arthur Riggs Diabetes & Metabolism Research Institute, Beckman Research Institute, City of Hope National Medical Center, Duarte, CA, USA

    Mohamed I. Husseiny

Authors
  1. Bahgat Fayed
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  2. Imene K. Lazreg
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  3. Razan B. AlHumaidi
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  4. Maryam A. A. A. Qasem
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  5. Bashayir M. Gh. N. Alajmy
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  6. Fatemh M. A. M. Bojbarah
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  7. Abiola Senok
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  8. Mohamed I. Husseiny
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  9. Sameh S. M. Soliman
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Contributions

MQ, BA, and FB wrote the first draft. BF, IL, and RA wrote the second draft and added more data. AS and MH revised the review and helped on the design of the review. SSMS generated the idea, designed the review, and wrote the final version. All authors agreed on publishing the review.

Corresponding author

Correspondence to Sameh S. M. Soliman.

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Fayed, B., Lazreg, I.K., AlHumaidi, R.B. et al. Intra-clade Heterogeneity in Candida auris: Risk of Management. Curr Microbiol 80, 295 (2023). https://doi.org/10.1007/s00284-023-03416-8

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