Cited by 132Antifungal resistance and susceptibilityBacterial biofilms and quorum sensingInfection Control in Healthcare

Candida auris Infection and Biofilm Formation: Going Beyond the Surface

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Horton, Mark V., Nett, Jeniel E.·2020·Current Clinical Microbiology Reports

Abstract

Purpose of Review: Emergent fungal pathogen C. auris is spreading in hospitals throughout the world and mortality rates for patients with invasive disease approach 60%. This species exhibits a heightened capacity to colonize skin, persist on hospital surfaces, rapidly disseminate in healthcare settings, and resist antifungal therapy. Recent Findings: Current investigations show that C. auris produces biofilms, surface-adherent communities that resist antifungals and withstand desiccation. These biofilms form when C. auris is growing on skin or in conditions expected in the hospital environment and on implanted medical devices. Summary: Here, we will highlight the topic of biofilm formation by C. auris. We illustrate how this process influences resistance to antimicrobials and promotes nosocomial transmission.

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Crossref · 10.1007/s40588-020-00143-7

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47 of 47 references verified0 citation errors · 0 not checkable

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  • Biofilm formation enhances Candida auris adhesive capacity and colonization efficiency.

    “with biofilm formation enhancing its adhesive capacity and colonization efficiency9–11”

    From The Wor2 phenotypic switching regulator controls biofilm formation in Candida auris (2026) · cites this paper as [11]

    The section ‘Does C. auris form biofilms in healthcare settings?’ describes biofilms as adherent communities and says growth as a biofilm on skin likely contributes to C. auris colonization. It does not establish that forming a biofilm increases the organism’s adhesive capacity relative to non-biofilm growth. (LLM, conf=0.82)

    Experimental — accuracy not yet measured
  • The cell wall adhesin Als4 plays a central role in biofilm formation in C. auris and is required for adhesion to both biotic and abiotic surfaces.

    “The cell wall adhesin Als4 plays a central role in biofilm formation in C. auris and is required for adhesion to both biotic and abiotic surfaces11,14,17,50,52.”

    From The Wor2 phenotypic switching regulator controls biofilm formation in Candida auris (2026) · cites this paper as [11]

    The sections on biofilms in healthcare settings describe C. auris growing as adherent biofilms on skin and catheter surfaces. They do not identify Als4 or establish that it is central to biofilm formation or required for adhesion to either surface type (searched: Als4 and adhesin-mediated adhesion). (LLM, conf=0.84)

    Experimental — accuracy not yet measured
  • Biofilms are often associated with increased persistence on environmental surfaces and colonization on host skin.

    “Since biofilms are often associated with increased persistence on the environmental surfaces and colonization on host skin4,5,11,49, this mutation could contribute to the prevalence and rapid transmission of C. auris.”
  • The WOR2 mutation could contribute to the prevalence and rapid transmission of C. auris.

    “Since biofilms are often associated with increased persistence on the environmental surfaces and colonization on host skin4,5,11,49, this mutation could contribute to the prevalence and rapid transmission of C. auris.”

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Research works printed but not linked: 2

  1. [21]Schelenz S, Hagen F, Rhodes JL, Abdolrasouli A, Chowdhary A, Hall A First hospital outbreak of the globally emerging Candida auris in a European hospital. Antimicrobial Resistance and Infection Control. 2016; 5(35). doi: 10.1186/s13756-016-0132-5. PMC5069812 27777756 · DOI · Paper page
  2. [32]Mukherjee PK, Chandra J, Kuhn DM, Ghannoum MA. Mechanism of fluconazole resistance in Candida albicans biofilms: phase-specific role of efflux pumps and membrane sterols. Infection and immunity. 2003; 71(8): 4333– 40. 12874310 PMC165995

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Authors
Horton, M. V., & Nett, J. E.
Affiliations
University of Wisconsin–Madison (US)
Corresponding author
Nett, Jeniel E.
Venue
Current Clinical Microbiology Reports
Published
2020-07-17
Volume
7
Issue
3
Pages
51-56
ISSN
2196-5471 (ISSN-L)
OpenAlex
W3042454077
Cited by
132
References
47
Citations by year
2026: 30 · 2025: 23 · 2024: 20 · 2023: 26 · 2022: 24 · 2021: 8 · 2020: 1
FWCI
1.93
Type
journal article
Language
en
Open access
Locations
  • Current Clinical Microbiology Reports (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • Doris Duke Charitable Foundation (2017074)
  • National Institute of Allergy and Infectious Diseases (R21AI159583, R01AI145939)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bacterial biofilms and quorum sensing
  • Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
Keywords
Candida auris, biofilm formation, antifungal resistance, nosocomial transmission, invasive candidiasis, skin colonization, biomedical implants, desiccation tolerance, emerging fungal pathogens

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