Scholarlink

Background <p><i>Candidozyma</i> (formerly <i>Candida</i>) <i>auris</i> (<i>C. auris</i>) has rapidly emerged as a global nosocomial pathogen due to its ability to withstand diverse antifungal pressures and spread within healthcare environments. Unlike many other Candida species, <i>C. auris </i>exhibits high baseline azole resistance and, more alarmingly, the capacity to acquire multidrug resistance during therapy, which complicates both patient management and infection control.</p> Objective <p>This review, for the first time, provides a detailed analysis of resistance acquired under antifungal pressure, distinguishing it from intrinsic resistance and highlighting the dynamic adaptive states that serve as transitional stages toward stable, heritable resistance.</p> Method <p>I explore how these survival strategies allow fungal cells to endure antifungal exposure, contribute to therapeutic failure, and ultimately facilitate the fixation of mutations in key molecular targets. Beyond mechanistic insights, this review emphasizes the clinical and diagnostic implications of resistance evolution. I also examine clinical management algorithms that integrate rapid diagnostics, source control, therapeutic drug monitoring, and evidence-based escalation or de-escalation strategies, supported by infectious disease consultation.</p> Conclusion <p>By framing resistance as a continuum from intrinsic traits to acquired stability under antifungal pressure, this review underscores the urgency of integrating laboratory vigilance, clinical stewardship, and genomic surveillance to mitigate the rising global threat of C. auris.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Beyond intrinsic resistance: novel insights into the emergence and management of resistance acquired in Candida auris upon antifungal exposure

  • 期刊论文

  • 发表日期：

    2026年4月28日

查看全文
  • Bahgat Fayed

摘要

Background

Candidozyma (formerly Candida) auris (C. auris) has rapidly emerged as a global nosocomial pathogen due to its ability to withstand diverse antifungal pressures and spread within healthcare environments. Unlike many other Candida species, C. auris exhibits high baseline azole resistance and, more alarmingly, the capacity to acquire multidrug resistance during therapy, which complicates both patient management and infection control.

Objective

This review, for the first time, provides a detailed analysis of resistance acquired under antifungal pressure, distinguishing it from intrinsic resistance and highlighting the dynamic adaptive states that serve as transitional stages toward stable, heritable resistance.

Method

I explore how these survival strategies allow fungal cells to endure antifungal exposure, contribute to therapeutic failure, and ultimately facilitate the fixation of mutations in key molecular targets. Beyond mechanistic insights, this review emphasizes the clinical and diagnostic implications of resistance evolution. I also examine clinical management algorithms that integrate rapid diagnostics, source control, therapeutic drug monitoring, and evidence-based escalation or de-escalation strategies, supported by infectious disease consultation.

Conclusion

By framing resistance as a continuum from intrinsic traits to acquired stability under antifungal pressure, this review underscores the urgency of integrating laboratory vigilance, clinical stewardship, and genomic surveillance to mitigate the rising global threat of C. auris.