Candida auris: Biology, Antifungal Resistance, and Clinical Challenges
คำสำคัญ:
Candida auris, Antifungal resistance, Healthcare-associated infections, Genomic surveillance, Infection prevention and controlบทคัดย่อ
Candida auris has emerged as a major global health threat due to its multidrug resistance, environmental persistence, diagnostic complexity, and propensity for healthcare-associated transmission. This review aimed to synthesize current evidence on the biology, antifungal resistance mechanisms, clinical significance, and emerging epidemiology of Candida auris, with particular emphasis on its implications for healthcare systems and the evolving situation in Thailand. A narrative review of published literature and relevant evidence from global studies and available reports from Thailand was conducted. The reviewed evidence indicates that the emergence of C. auris is driven by the convergence of environmental resilience, biofilm formation, genomic adaptability, and multidrug resistance. High levels of resistance to fluconazole and increasing resistance to amphotericin B and echinocandins substantially limit therapeutic options. The pathogen’s ability to persist on healthcare surfaces and colonize human skin facilitates sustained nosocomial transmission and recurrent outbreaks. Recent genomic studies have identified multiple resistance-associated mutations, although the clinical significance of several emerging variants remains uncertain. In Thailand, the detection of antifungal-resistant strains and the limited availability of advanced diagnostic capacity highlight important challenges for surveillance, laboratory identification, and infection prevention. Effective control of C. auris requires an integrated approach combining rapid diagnostics, antifungal stewardship, genomic surveillance, and rigorous infection-prevention measures.
เอกสารอ้างอิง
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