Mechanisms of pathogenicity for the emerging fungus Candida auris

Horton, Mark V.; Holt, Ashley M.; Nett, Jeniel E.

doi:10.1371/journal.ppat.1011843

Cited by 68Antifungal resistance and susceptibilityFungal Infections and StudiesFungal and yeast genetics research

Mechanisms of pathogenicity for the emerging fungus Candida auris

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Horton, Mark V., Holt, Ashley M., Nett, Jeniel E.·2023·PLOS Pathogens

DOI 10.1371/journal.ppat.1011843PMC PMC10735027

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Abstract

Candida auris recently emerged as an urgent public health threat, causing outbreaks of invasive infections in healthcare settings throughout the world. This fungal pathogen persists on the skin of patients and on abiotic surfaces despite antiseptic and decolonization attempts. The heightened capacity for skin colonization and environmental persistence promotes rapid nosocomial spread. Following skin colonization, C. auris can gain entrance to the bloodstream and deeper tissues, often through a wound or an inserted medical device, such as a catheter. C. auris possesses a variety of virulence traits, including the capacity for biofilm formation, production of adhesins and proteases, and evasion of innate immune responses. In this review, we highlight the interactions of C. auris with the host, emphasizing the intersection of laboratory studies and clinical observations.

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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 [52]
The “Adhesion, biofilm formation, and environmental persistence” section (page not provided) says ALS4 expression correlates with aggregation and heightened biofilm formation across C. auris isolates. It does not establish that Als4 is required for adhesion to either biotic or abiotic surfaces, and “central role” is stronger than the reported correlation. (LLM, conf=0.88)
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Research works printed but not linked: 2

[41]Horton MV, Johnson CJ, Kernien JF, Patel TD, Lam BC, Cheong JZA, et al. Candida auris Forms High-Burden Biofilms in Skin Niche Conditions and on Porcine Skin. mSphere. 2020; 5(1). Epub 2020/01/24. doi: 10.1128/mSphere.00910-19. 31969479 PMC6977180 · DOI · Paper page
[96]Horton MV, Johnson CJ, Zarnowski R, Andes BD, Schoen TJ, Kernien JF, et al. Candida auris Cell Wall Mannosylation Contributes to Neutrophil Evasion through Pathways Divergent from Candida albicans and Candida glabrata. mSphere. 2021; 6(3): e0040621. Epub 2021/06/24. doi: 10.1128/mSphere.00406-21. 34160238 PMC8265655 · DOI · Paper page

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Authors: Horton, M. V., Holt, A. M., & Nett, J. E.
Affiliations: University of Wisconsin–Madison (US)
Corresponding author: Nett, Jeniel E.
ORCID: Nett, Jeniel E.
Venue: PLOS Pathogens
Publisher: Public Library of Science (PLoS)
Published: 2023-12-21
Volume: 19
Issue: 12
Pages: e1011843
ISSN: 1553-7366 (ISSN-L)
1553-7374
DOI: 10.1371/journal.ppat.1011843
PMC: PMC10735027
OpenAlex: W4390062177
Cited by: 67
References: 94
Citations by year: 2026: 28 · 2025: 24 · 2024: 15
FWCI: 3.18
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (vor)
Locations: PLoS Pathogens (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders: NIH (R01AI145939, R21AI159583)
Topics: Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Fungal and yeast genetics research
Keywords: Candida auris, fungal pathogenicity, virulence factors, biofilm formation, adhesins, proteolytic enzymes, immune evasion, skin colonization, environmental persistence, nosocomial infections, bloodstream infection, device-related infection, host-pathogen interaction
MeSH terms: Candida auris, Antifungal Agents, Candida, Candidiasis, Disease Outbreaks, Humans, Virulence

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