This article has been reviewed according to Science X's editorial process and policies. Editors have highlighted the following attributes while ensuring the content's credibility: New research has revealed an unexpected new mechanism through which the killer fungus Candida auris is resisting antifungal drug treatment. A team led by the University of Exeter and City St George's, University of London, discovered that the fungus creates multiple versions of its entire genome, including mutating a gene that plays a role in cell wall integrity, called "Crazy-one" (CRZ1).
The study is set to appear in Nature Communications and is currently available on the bioRxiv preprint server. Study authors say their findings unlock a new mechanism that allows Candida auris to adapt to antifungal treatment and survive, which could lead to new ways to tackle the fungus. Candida auris was only described for the first time in 2008, and its origins remain a mystery.
Since it emerged, outbreaks have been reported on every continent, in more than 60 countries in total, including the U.K. It has been named a global public health threat and is on the World Health Organization's critical priority fungal pathogens list. Hugh Gifford, clinical lecturer at the University of Exeter's MRC Centre for Medical Mycology, is also an intensive care physician.
He said, "Candida auris is rare in the general population, but it's a deadly threat to patients in intensive care units. It clings to patient skin and surrounding equipment and can be transmitted from person to person—it's incredibly hard to eradicate. If infection enters a vulnerable patient's bloodstream, there is a 45% death rate.
"Outbreaks in intensive care units have been costly and highly disruptive. One unit in the U.K. had to close and undergo complete refurbishment to stop the outbreak, while another outbreak was estimated to cost £1 million to control." The research team was initially testing for drug resistance when a researcher accidentally left plates of cells incubating for longer than the required test period. The researcher returned to find that cells had unexpectedly grown during this additional time period.
They were surprised to find that further testing showed the deadly fungus had survived antifungal treatment by creating multiple versions of its own genome, thereby increasing its chances of mutating to evade the drug and survive. Sarah Murphy, former postdoctoral researcher at City St George's University of London and co-first author, said, "We initially set out to investigate why antifungal drugs weren't working to kill Candida auris, despite laboratory tests showing that they were not resistant and that the drugs should have been effective. We were surprised to discover an entirely new mechanism for this fungus to survive—particularly with luck playing a big part in the discovery.
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