Resistome and Resistance Mechanisms of Candidozyma Auris Clade IV: A Systematic Review
摘要
Candidozyma auris (formerly Candida auris) is an emerging pathogen that represents a public health problem due to its resistance to multiple classes of antifungals. The purpose of this review was to analyze the C. auris resistome and resistance mechanisms described for clade IV.
Recent FindingsSix groups of C. auris have been described, with clade IV (South American clade) being the cause of multiple outbreaks associated with invasive candidiasis and resistance to azoles, polyenes, and echinocandins.
SummaryResistant isolates of clade IV have been identified in countries across the Americas, Africa, and Asia. Both phenotypic and genotypic resistance to azoles, polyenes and echinocandins have been reported in these regions. The main resistance mechanisms described were alterations or overexpression of the lanosterol C14α-demethylase gene, functional mutations, and the overexpression of different transcription factors, including those related to efflux pumps. These findings highlight not only the genetic diversity of the C. auris clade IV resistome but also the ability of clade-specific strains and resistance genes to spread to other geographic areas, leading to epidemiological implications, and underscore the need for genomic surveillance to inform and improve treatment strategies.