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On the Origins of a Species: What Might Explain the Rise of Candida auris?

Centers for Disease Control and Prevention, Division of Foodborne, Waterborne, and Environmental Diseases, Mycotic Diseases Branch, Atlanta, GA 30329, USA
IHRC, Inc., Atlanta, GA 30346, USA
Centers for Disease Control and Prevention, Division of Healthcare Quality Promotion, Prevention and Response Branch, Atlanta, GA 30329, USA
Author to whom correspondence should be addressed.
J. Fungi 2019, 5(3), 58;
Received: 7 June 2019 / Revised: 28 June 2019 / Accepted: 1 July 2019 / Published: 6 July 2019
(This article belongs to the Special Issue Candida auris)
PDF [672 KB, uploaded 25 July 2019]


Candida auris is an emerging multidrug-resistant yeast first described in 2009 that has since caused healthcare-associated outbreaks of severe human infections around the world. In some hospitals, it has become a leading cause of invasive candidiasis. C. auris is markedly different from most other pathogenic Candida species in its genetics, antifungal resistance, and ability to spread between patients. The reasons why this fungus began spreading widely in the last decade remain a mystery. We examine available data on C. auris and related species, including genomic epidemiology, phenotypic characteristics, and sites of detection, to put forth hypotheses on its possible origins. C. auris has not been detected in the natural environment; related species have been detected in in plants, insects, and aquatic environments, as well as from human body sites. It can tolerate hypersaline environments and higher temperatures than most Candida species. We explore hypotheses about the pre-emergence niche of C. auris, whether in the environmental or human microbiome, and speculate on factors that might have led to its spread, including the possible roles of healthcare, antifungal use, and environmental changes, including human activities that might have expanded its presence in the environment or caused increased human contact. View Full-Text
Keywords: Candida auris; yeast; ecological niche; fungal infection; emerging infections Candida auris; yeast; ecological niche; fungal infection; emerging infections

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Jackson, B.R.; Chow, N.; Forsberg, K.; Litvintseva, A.P.; Lockhart, S.R.; Welsh, R.; Vallabhaneni, S.; Chiller, T. On the Origins of a Species: What Might Explain the Rise of Candida auris? J. Fungi 2019, 5, 58.

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