CO2 influences amphotericin B resistance and Candida auris colonization

Trends in Microbiology · 2026-03-10

Host–Candida auris interactions in the skin

PLoS Pathogens · 2026-03-27 · 1 citations

Candida auris is an emerging, multidrug-resistant fungal pathogen that causes healthcare-associated outbreaks and life-threatening systemic infections. Unlike other Candida species, C. auris exhibits a distinct capacity for persistent skin colonization. In this review, we summarize our current understanding of clinical risk factors and host-microbe interactions that underlie C. auris skin colonization and infection. We discuss fungal determinants, including the unique mannan outer layer, fungal adhesins, the protein kinase Hog1, and other pathways in C. auris that govern adaptation in the skin. Furthermore, we highlight host immune mechanisms, including cytokine mediators (IL-1Ra, IL-17) and innate immune cells (neutrophils, macrophages, innate lymphocytes), that shape the outcome of C. auris skin colonization and infection. We also discuss how excessive IFN-γ responses drive epithelial pathology at the cutaneous barrier and enhance fungal persistence. Finally, we outline emerging research directions to understand host and microbe factors governing long-term colonization, with implications for developing novel therapeutic and vaccine strategies against this skin-tropic, multidrug-resistant fungal pathogen.

Candida auris uses nutrient sensing to titrate its virulence potential and modulate immune response for host colonisation

Research Square · 2026-03-12

mGem: Fungal adhesins in <i>Candidozyma auris</i> confer unique fitness for skin colonization

mBio · 2026-03-09 · 1 citations

ABSTRACT Candidozyma auris (formerly Candida auris ) is an emerging multidrug-resistant fungal pathogen that causes life-threatening infections in humans. C. auris is distinct from other Candida species and exhibits exceptional capacity for skin colonization, resulting in nosocomial transmission and outbreaks of invasive infections. Fungal adhesins play a crucial role in skin colonization. With this perspective, we discuss the recent advances in the fungal adhesins of C. auris and how the divergence of adhesins in C. auris contributes to its unique fitness for skin colonization. We also discuss potential avenues to target fungal adhesins, which could pave the way for developing novel vaccine strategies and therapeutics to prevent skin colonization, nosocomial transmission, and invasive C. auris infections in humans.

Deletion of Galectin-3 Renders Mice Less Susceptible to <i>Candida auris</i> Skin Infection by Enhancing Antifungal Activity of Neutrophils

The Journal of Infectious Diseases · 2025-06-04

Candida auris is an emerging multidrug-resistant fungal pathogen that uniquely colonizes the skin. The factors regulating C auris colonization are poorly understood. In this study, we examined the role of galectin-3 during C auris skin infection. We found that deletion of galectin-3 enhances the antifungal activity of neutrophils and increases resistance to C auris skin infection. Mechanistically, galectin-3 negatively regulates GLUT4 expression, glucose uptake, reactive oxygen species production, and fungal killing by neutrophils. Collectively, our findings uncover a detrimental role for galectin-3 in neutrophil-mediated defense against C auris.

The Emerging Fungal Pathogen Candida auris Induces IFNγ to Colonize the Skin

PLoS Pathogens · 2025-04-28 · 11 citations

Candida auris is an emerging multidrug-resistant skin-tropic fungal pathogen that causes serious human infections. However, the factors that regulate C. auris skin infection in vivo are still unclear. In this study, we identified that, unlike Candida albicans, which induces IL-17-secreting protective effector Th17 cells, C. auris predominately induces IFNγ-secreting pathogenic Th1 cells during reinfection. Surprisingly, we found that IFNγ enhances skin infection of C. auris but not C. albicans. Mechanistically, IFNγ enhances skin infection of C. auris by dampening the protective IL-17 responses and increasing dermal damage. Furthermore, we identified that the development of Th1 cells occurs through IL-12, produced by C. auris-induced inflammatory macrophages and monocyte-derived dendritic cells. In addition, our findings reveal that C. auris unique cell wall outer mannan layer regulates the development of Th1 and Th17 cells. Collectively, our findings, for the first time, identified that C. auris induces IFNγ to persist in the skin. These findings help explain why C. auris but not C. albicans preferentially persist in the skin long-term, with the potential to identify novel therapeutic approaches to prevent and treat this emerging fungal pathogen in humans.

Yeast and filamentous <i>Candida auris</i> stimulate distinct immune responses in the skin

mSphere · 2024-06-21 · 10 citations

ABSTRACT Candida auris , an emerging multidrug-resistant fungal pathogen, predominately colonizes the human skin long term leading to subsequent life-threatening invasive infections. Fungal morphology is believed to play a critical role in modulating mucocutaneous antifungal immunity. In this study, we used an intradermal mouse model of C. auris infection to examine fungal colonization and the associated innate and adaptive immune response to yeast and filamentous C. auris strains. Our results indicate that mice infected with a filamentous C. auris had significantly decreased fungal load compared to mice infected with the yeast form. Mice infected with yeast and filamentous forms of C. auris stimulated distinct innate immune responses. Phagocytic cells (CD11b + Ly6G + neutrophils, CD11b + Ly6C hi inflammatory monocytes, and CD11b + MHCII + CD64 + macrophages) were differentially recruited to mouse skin tissue infected with yeast and filamentous C. auris . The percentage and absolute number of interleukin 17 (IL-17) producing innate lymphoid cells, TCRγδ + , and CD4 + T cells in the skin tissue of mice infected with filamentous C. auris were significantly increased compared to the wild-type of yeast strain. Furthermore, complementation of filamentous mutant strain of C. auris (Δ elm1 + ELM1 ) strain exhibited wild-type yeast morphology in vivo and induced comparable level of skin immune responses similar to mice infected with yeast strain. Collectively, our findings indicate that yeast and filamentous C. auris induce distinct local immune responses in the skin. The decreased fungal load observed in mouse skin infected with filamentous C. auris is associated with a potent IL-17 immune response induced by this morphotype. IMPORTANCE Candida auris is a globally emerging fungal pathogen that transmits among individuals in hospitals and nursing home residents. Unlike other Candida species, C. auris predominantly colonizes and persists in skin tissue resulting in outbreaks of systemic infections. Understanding the factors that regulate C. auris skin colonization and host immune response is critical to develop novel preventive and therapeutic approaches against this emerging pathogen. We identified that yeast and filamentous forms of C. auris induce distinct skin immune responses in the skin. These findings may help explain the differential colonization and persistence of C. auris morphotypes in skin tissue. Understanding the skin immune responses induced by yeast and filamentous C. auris is important to develop novel vaccine strategies to combat this emerging fungal pathogen.

Single-Cell Transcriptomics Unveils Skin Cell Specific Antifungal Immune Responses and IL-1Ra-IL-1R Immune Evasion Strategies of Emerging Fungal Pathogen <i>Candida auris</i>

bioRxiv (Cold Spring Harbor Laboratory) · 2024-10-22 · 1 citations

Abstract Candida auris is an emerging multidrug-resistant fungal pathogen that preferentially colonizes and persists in skin tissue, yet the host immune factors that regulate the skin colonization of C. auris in vivo are unknown. In this study, we employed unbiased single-cell transcriptomics of murine skin infected with C. auris to understand the cell type-specific immune response to C. auris. C. auris skin infection results in the accumulation of immune cells such as neutrophils, inflammatory monocytes, macrophages, dendritic cells, T cells, and NK cells at the site of infection. We identified fibroblasts as a major non-immune cell accumulated in the C. auris infected skin tissue. The comprehensive single-cell profiling revealed the transcriptomic signatures in cytokines, chemokines, host receptors (TLRs, C-type lectin receptors, NOD receptors), antimicrobial peptides, and immune signaling pathways in individual immune and non-immune cells during C. auris skin infection. Our analysis revealed that C. auris infection upregulates the expression of the IL-1RN gene (encoding IL-1R antagonist protein) in different cell types. We found IL-1Ra produced by macrophages during C. auris skin infection decreases the killing activity of neutrophils. Furthermore, C. auris uses a unique cell wall mannan outer layer to evade IL-1R-signaling mediated host defense. Collectively, our single-cell RNA seq profiling identified the transcriptomic signatures in immune and non-immune cells during C. auris skin infection. Our results demonstrate the IL-1Ra and IL-1R-mediated immune evasion mechanisms employed by C. auris to persist in the skin. These results enhance our understanding of host defense and immune evasion mechanisms during C. auris skin infection and identify potential targets for novel antifungal therapeutics.

The <i>Candida auris</i> Hog1 MAP kinase is essential for the colonization of murine skin and intradermal persistence

bioRxiv (Cold Spring Harbor Laboratory) · 2024-03-18 · 4 citations

Abstract Candida auris , a multidrug-resistant human fungal pathogen, was first identified in 2009 in Japan. Since then, systemic C. auris infections have now been reported in more than 50 countries, with mortality rates of 30-60%. A major contributing factor to its high inter- and intrahospital clonal transmission is that C. auris, unlike most Candida species, displays unique skin tropism and can stay on human skin for a prolonged period. However, the molecular mechanisms responsible for C. auris skin colonization, intradermal persistence, and systemic virulence are poorly understood. Here, we report that C. auris Hog1 mitogen-activated protein kinase (MAPK) is essential for efficient skin colonization, intradermal persistence, as well as systemic virulence. RNA-seq analysis of wildtype parental and hog1 Δ mutant strains revealed marked down-regulation of genes involved in processes such as cell adhesion, cell-wall rearrangement, and pathogenesis in hog1 Δ mutant compared to the wildtype parent. Consistent with these data, we found a prominent role for Hog1 in maintaining cell-wall architecture, as the hog1 Δ mutant demonstrated a significant increase in cell-surface β-glucan exposure and a concomitant reduction in chitin content. Additionally, we observed that Hog1 was required for biofilm formation in vitro and fungal survival when challenged with primary murine macrophages and neutrophils ex vivo . Collectively, these findings have important implications for understanding the C. auris skin adherence mechanisms and penetration of skin epithelial layers preceding bloodstream infections. Importance Candida auris is a World Health Organization (WHO) fungal priority pathogen and an urgent public health threat recognized by the Centers for Disease Control and Prevention (CDC). C. auris has a unique ability to colonize human skin. It also persists on abiotic surfaces in healthcare environments for an extended period of time. These attributes facilitate the inter- and intrahospital clonal transmission of C. auris . Therefore, understanding C. auris skin colonization mechanisms are critical for infection control, especially in hospitals and nursing homes. However, despite its profound clinical relevance, the molecular and genetic basis of C. auris skin colonization mechanisms are poorly understood. Herein, we present data on the identification of the Hog1 MAP kinase as a key regulator of C. auris skin colonization. These findings lay foundation for further characterization of unique mechanisms that promote fungal persistence on human skin.

Single-cell transcriptomics unveils skin cell specific antifungal immune responses and IL-1Ra- IL-1R immune evasion strategies of emerging fungal pathogen Candida auris

PLoS Pathogens · 2024-11-13 · 16 citations

Candida auris is an emerging multidrug-resistant fungal pathogen that preferentially colonizes and persists in skin tissue, yet the host immune factors that regulate the skin colonization of C. auris in vivo are unknown. In this study, we employed unbiased single-cell transcriptomics of murine skin infected with C. auris to understand the cell type-specific immune response to C. auris. C. auris skin infection results in the accumulation of immune cells such as neutrophils, inflammatory monocytes, macrophages, dendritic cells, T cells, and NK cells at the site of infection. We identified fibroblasts as a major non-immune cell accumulated in the C. auris infected skin tissue. The comprehensive single-cell profiling revealed the transcriptomic signatures in cytokines, chemokines, host receptors (TLRs, C-type lectin receptors, NOD receptors), antimicrobial peptides, and immune signaling pathways in individual immune and non-immune cells during C. auris skin infection. Our analysis revealed that C. auris infection upregulates the expression of the IL-1RN gene (encoding IL-1R antagonist protein) in different cell types. We found IL-1Ra produced by macrophages during C. auris skin infection decreases the killing activity of neutrophils. Furthermore, C. auris uses a unique cell wall mannan outer layer to evade IL-1R-signaling mediated host defense. Collectively, our single-cell RNA seq profiling identified the transcriptomic signatures in immune and non-immune cells during C. auris skin infection. Our results demonstrate the IL-1Ra and IL-1R-mediated immune evasion mechanisms employed by C. auris to persist in the skin. These results enhance our understanding of host defense and immune evasion mechanisms during C. auris skin infection and identify potential targets for novel antifungal therapeutics.