European Journal of Clinical Microbiology & Infectious Diseases最新文献

{"title":"Contribution of sonication to the microbiology diagnosis of periprosthetic joint infection: Retrospective study of real-world data.","authors":"Alia Barthel, Stéphane Klein, Lucas Niglis, Cyril Boeri, Emilie Talagrand-Reboul, François Severac, Jeannot Gaudias, Jean-Yves Jenny, Pierre Boyer, Cécile Ronde-Oustau","doi":"10.1007/s10096-026-05575-5","DOIUrl":"10.1007/s10096-026-05575-5","url":null,"abstract":"<p><strong>Purpose: </strong>Despite the progress made in the treatment of periprosthetic joint infections, identifying the causative pathogen remains a challenge. Optimal antibiotic therapy requires a confirmed diagnosis, which relies on two positive cultures for the same microorganism. Even though both can produce consistent results, there is little data on the combination of sonication fluid culture (SFC) with standard fluid and tissue cultures for the microbiology diagnosis. We hypothesized that this combination could increase the number of confirmed microbiology diagnoses.</p><p><strong>Methods: </strong>This was retrospective, descriptive, single-centre study of consecutive patients who underwent a complete change of their hip or knee prosthesis between January 2019 and September 2021 due to a suspected infection. We expected that at least 5% of patients would have the infectious role of a micro-organism confirmed with sonication. The effect of prior antibiotic therapy was analysed on a subset of patients.</p><p><strong>Results: </strong>The analysis involved 223 patients with PJI diagnosis, 73 of whom had received antibiotics. The rate of confirmed microbiology diagnosis confirmed by one single positive sample culture plus SFC was 13.5% [9.6-18.6]. The rate was not significantly different in patients who had received antibiotic therapy (p = 0.960).</p><p><strong>Conclusion: </strong>According to our results, sonication could improve the rate of confirmed microbiology diagnosis of a PJI in our study, both in patients who previously received antibiotic therapy and in patients who had not yet been treated. This could make it a useful supplement to periprosthetic sampling in current practice.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"3037-3044"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148316399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: \"Dalbavancin for infective endocarditis: a systematic review of effectiveness, safety, and dosing\".","authors":"Isheeka Lohana, Bhoomeeka Jayramdass","doi":"10.1007/s10096-026-05563-9","DOIUrl":"10.1007/s10096-026-05563-9","url":null,"abstract":"","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"3275-3276"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148197793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A review of bloodstream infections-pathogens, pathogenesis, diagnostic strategies, treatment methods-challenges and future aspects.","authors":"Amit Kumar, Adesh Kumar, Ashu Tyagi, Raj Singh, Myank Uday Charaya","doi":"10.1007/s10096-026-05577-3","DOIUrl":"10.1007/s10096-026-05577-3","url":null,"abstract":"<p><strong>Purpose: </strong>Bloodstream infections (BSIs) remain a major cause of morbidity and mortality worldwide and continue to represent a substantial challenge to modern healthcare systems. These infections arise when pathogenic microorganisms gain access to the bloodstream, triggering systemic inflammatory responses that may progress to sepsis, septic shock, multi-organ dysfunction, and death. This review provides a comprehensive overview of the historical development, epidemiology, pathogenesis, diagnosis, treatment, and future perspectives of BSIs. The major bacterial, fungal, viral, and parasitic pathogens associated with BSIs are discussed, with particular emphasis on their virulence attributes, mechanisms of immune evasion, antimicrobial resistance, and clinical significance.</p><p><strong>Methods: </strong>A comprehensive literature review was conducted using peer-reviewed publications, clinical guidelines, surveillance reports, and systematic reviews published between 2010 and mid-2026. Evidence related to bacterial, fungal, viral, and parasitic bloodstream pathogens, host-pathogen interactions, diagnostic modalities, antimicrobial resistance mechanisms, and emerging therapeutic and diagnostic innovations was critically evaluated and integrated.</p><p><strong>Results: </strong>BSIs continue to impose a substantial healthcare burden, driven by increasing antimicrobial resistance, delayed diagnosis, and diverse pathogen-specific virulence mechanisms. Bacterial pathogens remain the predominant cause of BSIs, whereas Candida species represent the leading fungal agents. Advances in molecular diagnostics, metagenomic sequencing, biomarker-guided testing, and artificial intelligence-assisted analyses have substantially improved rapid pathogen detection and therapeutic decision-making. Precision medicine, genomic surveillance, and novel antimicrobial agents show considerable promise for enhancing clinical management and addressing multidrug-resistant infections.</p><p><strong>Conclusion: </strong>Bloodstream infections remain a major global health challenge due to their complex pathogenesis, increasing antimicrobial resistance, and high associated mortality. Improving patient outcomes requires early and accurate pathogen identification, prompt initiation of targeted antimicrobial therapy, effective antimicrobial stewardship, and continuous epidemiological surveillance. The integration of next-generation diagnostics, artificial intelligence-assisted pathogen detection, genomic surveillance, and precision medicine has the potential to transform BSI diagnosis and management by enabling rapid, individualized therapeutic interventions.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"2939-2987"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148367408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MUREAPLEXE: A multiplex recombinant antigen-based ELISA expanding the serological detection spectrum of urogenital mycoplasmas.","authors":"Sarra Abassi, Safa Boujemaa, Imen Chniba, Sabrina Zidi, Nadine Khadraoui, Behija Mlik, Wassim Y Almawi, Boutheina Ben Abdelmoumen Mardassi","doi":"10.1007/s10096-026-05566-6","DOIUrl":"10.1007/s10096-026-05566-6","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to improve the serological identification of urogenital mycoplasmas through the development of MUREAPLEXE, a recombinant protein-based multiplex ELISA allowing the simultaneous and specific detection of antibodies against Metamycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyticum.</p><p><strong>Methods: </strong>Genes encoding the major surface antigens Vaa and P120' of M. hominis, MBA3 of U. parvum and MBA8 of U. urealyticum were cloned into the prokaryotic expression vector pGEX-4T-1 and expressed in E. coli BL21. Recombinant GST-fusion proteins were purified by affinity chromatography using Glutathione-Sepharose 4B beads and were used to optimize an indirect multiplex ELISA. Both assays were subsequently evaluated using 162 patient sera that had been previously characterized by indirect immunofluorescence (IIF) and Western blot analysis.</p><p><strong>Results: </strong>Relative to IIF, both ELISA assays demonstrated high sensitivity. All tested sera showed reactivity with their corresponding recombinant antigens. Statistical analyses demonstrated a significant correlation between the two ELISA tests. However, MUREAPLEXE demonstrated markedly higher specificity.</p><p><strong>Conclusion: </strong>Given its high sensitivity and specificity for the simultaneous serological identification of M. hominis, U. parvum, and U. urealyticum, MUREAPLEXE may provide a robust and reliable complementary tool for the monitoring of urogenital mycoplasmas.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"3135-3148"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research progress on detection technologies for Mycoplasma pneumoniae.","authors":"Huanhuan Wu, Fang Jiang, Siyu Tian","doi":"10.1007/s10096-026-05594-2","DOIUrl":"10.1007/s10096-026-05594-2","url":null,"abstract":"<p><p>Mycoplasma pneumoniae (M. pneumoniae) is a primary pathogen responsible for community-acquired pneumonia (CAP), particularly prevalent among children and adolescents. The recent global resurgence of infection cases, coupled with the rapid dissemination of macrolide-resistant M. pneumoniae (MRMP), underscores the critical clinical need for rapid and precise diagnostic technologies. This article systematically reviews the evolutionary trajectory of detection technologies, covering the transition from traditional culture and serological testing to modern molecular diagnostic techniques. It critically analyzes emerging platforms, including isothermal amplification, CRISPR/Cas-based diagnostics, microfluidic chips, and biosensors. It explores their potential in facilitating point-of-care testing (POCT) and simultaneous antimicrobial resistance profiling. Despite continuous technological advancements, challenges remain regarding the differentiation between active infection and colonization, as well as the balancing of cost-effectiveness. The future of M. pneumoniae diagnostics lies in the deep integration of multidisciplinary biotechnologies with artificial intelligence, aiming to construct intelligent \"sample-to-answer\" solutions to optimize clinical antimicrobial stewardship.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"3003-3017"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148445262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating T-cell phenotypes are influenced by prior Staphylococcus aureus exposure in hemodialysis patients.","authors":"Daniel J Dempsey, Sultan Imangaliyev, Tracey J Claxton, Emmett Browne, Roisin Connolly, James Ng, Mark Denton, Brenda Griffin, Mark A Little, Hilary Humphreys, Arthur White, Rachel M McLoughlin","doi":"10.1007/s10096-026-05581-7","DOIUrl":"10.1007/s10096-026-05581-7","url":null,"abstract":"<p><p>Staphylococcus aureus bloodstream infections are a significant risk for hemodialysis patients, who would significantly benefit from a preventative vaccine. To-date S. aureus vaccine trials have failed, in part due to lack of consideration of pre-existing immune imprints in relevant patient cohorts. Using a machine learning algorithm this study revealed, prior S. aureus exposure in a cohort of 180 hemodialysis patients, was associated with an increase in circulating S. aureus antigen-specific exTh17 cells and reduced antigen-specific IL-10 producing CD4 cells and circulating NK cells and Vδ2 cells. It provides novel insights into pre-existing S. aureus immunity in hemodialysis patients that could inform next generation vaccine development.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"3269-3274"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148455031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breaking barriers: Implementation of a tuberculosis preventive treatment protocol among newly eligible populations with promising results.","authors":"Paloma Gijón, Teresa Aldámiz, Ana Isabel Ramos-Lisbona, Flor Valenzuela, Cristina Rincón, Raquel Carrillo, Patricia Muñoz, Maria Jesus Ruiz-Serrano","doi":"10.1007/s10096-026-05570-w","DOIUrl":"10.1007/s10096-026-05570-w","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organization emphasizes tuberculosis preventive treatment (TPT) as key to TB elimination. Implementation faces risk-benefit and adherence challenges. We implemented a structured TPT protocol at Hospital Gregorio Marañón with telephone support, personalized selection of currently available regimens, and toxicity management.</p><p><strong>Objective: </strong>To assess the structured TPT protocol in achieving complete preventive treatment (CPT) and identify factors associated with non-completion (NCPT).</p><p><strong>Methods: </strong>Retrospective analysis of a prospective cohort (2017-2024) of adults referred to the TB Unit. All causes of TPT were included per Spanish guidelines, except people living with HIV, who are followed in a separate clinic. Demographics, comorbidities, and outcomes were prospective collected. Univariate and multivariable logistic regression were used to identify predictors.</p><p><strong>Results: </strong>Of 554 patients, 542 (97.8%) initiated TPT: close TB contacts (37.6%), immunosuppression (27.9%), and indications for immunomodulatory therapy (34.5%). Overall CPT was 86.5% (80.3% in those > 75 years; 90.7% in ages 35-54). Cancer predicted NCPT (aOR 2.25; 95% CI 1.21-4.21; p = 0.011). Among 73 NCPT cases, toxicity was the main cause (42.5%), followed by voluntary withdrawal (27.4%), social problems (20.5%, mainly in young immigrants), intercurrent disease (9.6%, notably cancer). Polypharmacy (aOR 2.51; 95% CI 1.13-5.60; p = 0.023) and inflammatory disease (aOR 2.25; 95% CI 1.06-4.75; p = 0.034) independently predicted toxicity-related NCPT.</p><p><strong>Conclusions: </strong>The structured TPT protocol was associated with high CPT rates (86.5%), with excellent safety. Cancer predicted NCPT, polypharmacy and inflammatory disease predicted toxicity leading to NCPT. Similar studies are needed to compare our results.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"3057-3067"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148351011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular epidemiology of Dientamoeba fragilis coinfections with Blastocystis sp. and Giardia duodenalis in symptomatic patients from Valencia, Spain.","authors":"Marta García-Hita, Jorge Ferriz, Susana Cifre, Gabriela Tapia-Veloz, Araceli Molina, David Carmena, Maria Trelis","doi":"10.1007/s10096-026-05586-2","DOIUrl":"10.1007/s10096-026-05586-2","url":null,"abstract":"<p><strong>Purpose: </strong>Dientamoeba fragilis is a cosmopolitan intestinal protist with an insufficiently understood life cycle and pathogenicity. Diagnosis by light microscopy is challenging, leading to significant underdiagnosis. Two genotypes (1 and 2) have been described, with genotype 1 being the most frequently detected worldwide. As no molecularly characterized isolates from Spain have been reported, we performed a molecular characterization and evaluated sociodemographic factors of D. fragilis in patients coinfected with Blastocystis sp. and/or Giardia duodenalis.</p><p><strong>Methods: </strong>Using a multiplex qPCR assay (Allplex™ GI-Parasite Assay, Seegene), we analyzed 354 stool samples previously identified as positive for Blastocystis sp. (n = 276), G. duodenalis (n = 63), or both (n = 15) by light microscopy. Eligible positive samples were selected for conventional PCR targeting the SSU rRNA gene and subsequent Sanger sequencing.</p><p><strong>Results: </strong>D. fragilis was detected in 34.5% of samples by qPCR; 32.3% of Blastocystis-positive, 44.9% of Giardia-positive and 46.7% of coinfected samples. We successfully sequenced 22 isolates, all corresponding to genotype 1, identifying two distinct intra-genotypic sequence variants. Younger age was positively associated with D. fragilis, with individuals coinfected with Blastocystis sp. being markedly younger than those monoinfected. Patients with G. duodenalis and D. fragilis were mainly under 15 years of age.</p><p><strong>Conclusion: </strong>This study provides the first genotyping of D. fragilis in Spain, demonstrating the circulation of two genotype 1 variants. Findings highlight the underdiagnosis of D. fragilis and its high prevalence in young patients with other fecal-orally transmitted protists. Evaluating coinfections is crucial to understanding parasite relationships and should be considered for clinical management, especially when symptoms persist.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"3181-3191"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adaptive susceptibility shifts in Candidozyma auris following biocidal exposure: Exploratory effects on antifungal and biocidal susceptibility.","authors":"Handenur Ulukan, Rufig Hasanli, Dilan Cumert, Sena Algın, Sidre Erganiş, Elif Ayça Şahin, Fatma Bozdağ, Sultan Pınar Çetintepe, Ayse Kalkanci","doi":"10.1007/s10096-026-05571-9","DOIUrl":"10.1007/s10096-026-05571-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Candidozyma (Candida) auris has emerged as a multidrug-resistant pathogen with the capacity to persist in healthcare environments. This study investigated bidirectional interactions between biocidal exposure and antifungal susceptibility, including both minimum inhibitory concentrations (MICs) and minimum fungicidal concentrations (MFCs), in a real-life disinfection scenario, and further evaluated membrane dynamics and efflux pump activity using rhodamine 6G (R6G) uptake/efflux assays.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Four clinical isolates and one reference strain were exposed to ethanol (EtOH), chlorine (CHLOR), chlorhexidine (CHX), and triclosan (TRC) for 30 s, 5 min, and 24 h. Post-exposure MIC and MFC values were determined for antifungals-amphotericin B (AMB), voriconazole (VOR), and anidulafungin (ANI)-as well as for the same biocides, following CLSI M27-A3 guidelines. Data were expressed as log₂ fold changes relative to baseline. All experiments were performed in technical triplicates to ensure reproducibility of MIC/MFC measurements. Statistical analyses were conducted using biological comparisons across the five parental isolates and their corresponding post-exposure derivatives.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In this exploratory proof-of-concept study, a total of 64 isolate-condition datasets derived from five parental C. auris isolates were evaluated under 12 biocidal exposure conditions, allowing assessment of time-dependent adaptive susceptibility shifts across multiple exposure scenarios. In total, 30 short-term (30 s / 5 min) and 2 long-term (24 h) derivatives were generated from 4 different biocides (EtOH, CHX, TRC, and limited CHLOR data). All 32 biocide-exposed isolates underwent MIC/MFC testing against three antifungals (AMB, VOR, ANI) and three main biocides (EtOH, CHX, TRC), followed by biocide-free serial passaging to assess stability. Baseline MIC distributions were as follows: AMB 0.25-2 µg/mL, VOR 4-16 µg/mL, and ANI 0.01-0.25 µg/mL. After exposure, VOR MICs showed significant reduction to 3.05-4.22 mg/L with TRC exposure being nominally significant before FDR adjustment (raw p=0.043). AMB remained stable (0.47-0.67 mg/L, all p&gt;0.05), while ANI showed non-significant variability in MIC values to 0.04-0.09 mg/L (non-significant, p&gt;0.05). Biocidal MICs also showed changes: EtOH remained heterogeneous (p&gt;0.05), CHX decreased significantly with CHX pre-exposure (p=0.042), and TRC showed non-significant increases. Biocidal exposure produced agent-specific antifungal effects: ANI demonstrated modest non-significant directional shifts in MIC values across all biocides, AMB remained stable with heterogeneous responses, and VOR displayed significant MIC reduction only with TRC exposure. TRC and CHX yielded the most consistent effects in both antifungal and biocidal susceptibility. R6G assays suggested alterations in efflux activity after TRC and CHX exposure, whereas EtOH impaired efflux. Most changes","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"3081-3093"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unraveling clade-specific differences in Candida auris: evolution, adaptation, and pathogenicity.","authors":"Preeti Sharma, Vinay Kumar Bari, Ritu Pasrija","doi":"10.1007/s10096-026-05569-3","DOIUrl":"10.1007/s10096-026-05569-3","url":null,"abstract":"<p><p>Since its 2009 emergence, Candida auris (now also known as Candidozyma auris) has evolved from a rare isolate into a global \"critical priority\" pathogen. This rapid expansion is defined by its unique population structure consisting of six distinct genomic clades with starkly different evolutionary trajectories, phenotypic traits, and clinical risks. We conducted a systematic synthesis of literature from PubMed, Scopus, and Google Scholar (2009-2026), focusing on comparative genomics, clade-specific virulence, and diagnostic accuracy. A total of 64 studies were analyzed to identify patterns in clade divergence and antifungal resistance. Our analysis reveals that C. auris is not a monolithic threat but a complex of diverse lineages with specialized adaptations. Clade I (South Asian) and Clade IV (South American) represent the highest clinical risk due to hyper-virulence and high rates of multi-drug resistant (MDR) strains. In contrast, Clade II (East Asian) was initially associated with localized ear infections; recent genomic data show an expanding pathogenic profile with emerging bloodstream infections. Our review also identifies Clade V (Iranian) as a genetically distinct group and highlights the recent identification of Clade VI (Indomalayan) as a distinct lineage, suggesting a long-standing environmental reservoir. Furthermore, we identify critical \"blind spots\" in automated diagnostic platforms (VITEK^® 2, BD Phoenix) where phenotypic variations in Clades II and III lead to frequent misidentification as Candida haemulonii or Candida famata. This review proposes a \"clade-aware\" framework for public health. While frontline antifungal treatment remains standardized regardless of lineage, we argue that effective long-term management and outbreak containment require integrating genomic surveillance with clade-specific infection control. By identifying high-biofilm clades (Clade I) or hyper-virulent lineages (Clade IV), public health systems can implement more targeted containment strategies, moving toward a precision-based approach to managing this fungal pathogen.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"3241-3250"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148316384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}