Treating infections that caused by Drug-resistant Candida Auris

 Treating infections caused by drug-resistant Candida auris poses a significant challenge due to limited treatment options and the potential for adverse outcomes. Candida auris is an emerging multidrug-resistant fungal pathogen that is associated with healthcare-associated infections, particularly in immunocompromised patients. Here's an overview of the treatment strategies for drug-resistant Candida auris infections, along with relevant references:

1. Antifungal Susceptibility Testing:

   • Antifungal susceptibility testing is essential to guide treatment decisions for Candida auris infections. Testing helps identify which antifungal agents are still effective against the specific strain of Candida auris.
   • Reference: Chowdhary, A., & Meis, J. F. (2017). Candida auris: A rapidly emerging cause of hospital-acquired multidrug-resistant fungal infections globally. PLoS Pathogens, 13(5), e1006290.

2. Echinocandin Therapy:

   • Echinocandins, such as caspofungin, micafungin, and anidulafungin, are often considered first-line agents for the treatment of Candida auris infections.
   • However, some strains of Candida auris have developed resistance to echinocandins, highlighting the need for susceptibility testing and alternative treatment options.
   • Reference: Kordalewska, M., & Perlin, D. S. (2019). Identification of drug resistant Candida auris. Frontiers in Microbiology, 10, 1918.

3. Triazole Therapy:

   • Triazole antifungal agents, such as fluconazole, voriconazole, and isavuconazole, are commonly used to treat Candida infections.
   • However, Candida auris strains may exhibit varying degrees of resistance to triazoles, necessitating susceptibility testing and alternative treatment approaches.
   • Reference: Sherry, L., Ramage, G., & Kean, R. (2017). Biofilm-forming capability of highly virulent, multidrug-resistant Candida auris. Emerging Infectious Diseases, 23(2), 328.

4. Amphotericin B Therapy:

   • Amphotericin B, a polyene antifungal agent, is often used as a salvage therapy for Candida auris infections that are resistant to other antifungal agents.
   • However, amphotericin B is associated with significant nephrotoxicity and other adverse effects, limiting its use as a first-line treatment option.
   • Reference: Schelenz, S., Hagen, F., Rhodes, J. L., Abdolrasouli, A., Chowdhary, A., Hall, A., ... & Fisher, M. C. (2016). First hospital outbreak of the globally emerging Candida auris in a European hospital. Antimicrobial Resistance & Infection Control, 5(1), 35.

5. Combination Therapy:

   • Combination antifungal therapy, using two or more antifungal agents with different mechanisms of action, may be considered for severe or refractory Candida auris infections.
   • However, the optimal combination regimen and the efficacy of combination therapy remain areas of active research.
   • Reference: Berkow, E. L., & Lockhart, S. R. (2018). Fluconazole resistance in Candida species: a current perspective. Infection and Drug Resistance, 11, 165.

6. Infection Control Measures:

   • In addition to antifungal therapy, implementing strict infection control measures, including hand hygiene, contact precautions, environmental cleaning, and surveillance cultures, is essential to prevent the spread of Candida auris within healthcare facilities.
   • Reference: Schelenz, S., Hagen, F., Rhodes, J. L., Abdolrasouli, A., Chowdhary, A., Hall, A., ... & Fisher, M. C. (2016). First hospital outbreak of the globally emerging Candida auris in a European hospital. Antimicrobial Resistance & Infection Control, 5(1), 35.

Treating infections caused by drug-resistant Candida auris requires a multifaceted approach that includes antifungal stewardship, susceptibility testing, combination therapy, infection control measures, and ongoing research into novel treatment options. Collaboration among healthcare providers, researchers, and policymakers is essential to address the growing threat of Candida auris infections effectively