Candidozyma auris (formerly Candida auris): resistant, long lasting, and everywhere
Düsseldorf University Hospital · Cologne Excellence Cluster on Cellular Stress Responses in Aging Associated Diseases · +5 more institutions
Abstract
Invasive fungal diseases represent a significant global health concern, with Candidozyma auris (formerly Candida auris) emerging as a major healthcare-associated pathogen. Its multidrug resistance, environmental persistence, prolonged skin colonization, and efficient nosocomial transmission have driven sustained outbreaks and endemicity worldwide, and recent taxonomic changes have further complicated surveillance and diagnostics.
This narrative review summarizes current evidence on the taxonomy, epidemiology, clinical impact, antifungal resistance, transmission, and infection prevention and control (IPC) of C. auris, highlighting outbreak drivers, regional endemicity, and key gaps relevant to surveillance and policy. SOURCES: We conducted a structured narrative review of peer-reviewed and grey literature published between 2009 and 2025, drawing from PubMed/MEDLINE, Embase, Scopus, Web of Science, and major public health websites, such as the WHO, the CDC, the European Centre for Disease Prevention and Control, the UK Health Security Agency, and national surveillance portals. CONTENT: C. auris has rapidly evolved into an endemic healthcare threat across multiple continents, with substantial regional variation in incidence, outbreak dynamics, antifungal resistance, and control capacity. Candidemia mortality averages ∼30% but differs by region and patient population. Azole resistance is widespread in several clades, whereas resistance to amphotericin B and echinocandins is increasingly reported, particularly in high-endemic settings. Outbreaks are sustained by environmental persistence, prolonged skin colonization, and healthcare-associated transmission, amplified by intensive care exposure, antimicrobial pressure, and system strain during the COVID-19 pandemic. Despite broadly aligned IPC guidance, major challenges persist in screening, decolonization, laboratory identification, and long-term outbreak control.
Citation impact
- FWCI
- 112.66
- Percentile
- 100%
- References
- 59
Authors
3- JSJon Salmanton-GarcíaCorresponding
Düsseldorf University Hospital, Cologne Excellence Cluster on Cellular Stress Responses in Aging Associated Diseases, University Hospital Cologne, Heinrich Heine University Düsseldorf
- JNJoão Nóbrega de Almeida
Hospital Israelita Albert Einstein, Hospital São Paulo
- ALArnaldo Lopes Colombo
Universidade Federal de São Paulo
Topics & keywords
- Candida auris
- Public health
- Health care
- Global health
- Nomenclature
- Control (management)