Environmental reservoirs of the drug-resistant pathogenic yeast Candida auris

PLoS Pathog. 2023 Apr 13;19(4):e1011268. doi: 10.1371/journal.ppat.1011268. eCollection 2023 Apr.

Abstract

Candia auris is an emerging human pathogenic yeast; yet, despite phenotypic attributes and genomic evidence suggesting that it probably emerged from a natural reservoir, we know nothing about the environmental phase of its life cycle and the transmission pathways associated with it. The thermotolerant characteristics of C. auris have been hypothesised to be an environmental adaptation to increasing temperatures due to global warming (which may have facilitated its ability to tolerate the mammalian thermal barrier that is considered a protective strategy for humans against colonisation by environmental fungi with pathogenic potential). Thus, C. auris may be the first human pathogenic fungus to have emerged as a result of climate change. In addition, the release of antifungal chemicals, such as azoles, into the environment (from both pharmaceutical and agricultural sources) is likely to be responsible for the environmental enrichment of resistant strains of C. auris; however, the survival and dissemination of C. auris in the natural environment is poorly understood. In this paper, we critically review the possible pathways through which C. auris can be introduced into the environment and evaluate the environmental characteristics that can influence its persistence and transmission in natural environments. Identifying potential environmental niches and reservoirs of C. auris and understanding its emergence against a backdrop of climate change and environmental pollution will be crucial for the development of effective epidemiological and environmental management responses.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antifungal Agents / therapeutic use
  • Candida auris*
  • Candida* / genetics
  • Climate Change
  • Humans
  • Mammals
  • Microbial Sensitivity Tests

Substances

  • Antifungal Agents

Grants and funding

RQ was supported by the UKRI Natural Environment Research Council (NE/S005196/1). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.