Candidozyma (also known as Candida) auris, now comprising six clades, has emerged globally as an important cause of nosocomial infection and outbreaks. Unique and concerning characteristics include its ability to persist in the environment and resist disinfectants and antifungals, as well as a propensity to cause invasive infection with mortality from bloodstream infections estimated at >40%. Other challenges have included isolation and identification in the laboratory, though newer enrichment protocols, chromogenic media, and Matrix-Assisted Laser Desorption/Ionization Time-of-Flight mass spectrometry (MALDI-TOF MS) databases are more promising. There is a lack of interpretative criteria for "susceptibility" or "resistance" using standardized methodology, and additionally a paucity of clinical trial evidence to guide therapy, particularly for isolates resistant to usual first-line antifungals. Given the issues with multi-drug resistance, studies exploring the use of ibrexafungerp and fosmanogepix alone or in combination with echinocandins are urgently needed. In addition to evaluating combination therapy and newer antifungals, future priorities for C. auris include increasing global awareness, the development of accessible, rapid diagnostic methods and antifungal susceptibility methodology, investigation of optimal disinfection strategies, and clinical studies better characterizing clinical outcomes.
Jordan et al. (Sat,) studied this question.