Psychogenetic, genetic and epigenetic mechanisms in Candida auris: Role in drug resistance
Ali A Rabaan 1, Khalid Eljaaly 2, Wadha A Alfouzan 3, Abbas Al Mutair 4, Saad Alhumaid 5, Amal H Alfaraj 6, Yahya Aldawood 7, Abdulmonem A Alsaleh 7, Hawra Albayat 8, Reyouf Al Azmi 9, Nawal AlKaabi 10, Samira J Alzahrani 11, Salma AlBahrani 12, Tarek Sulaiman 13, Abeer N Alshukairi 14, Abdulmonem A Abuzaid 15, Mohammed Garout 16, Rafiq Ahmad 17, Javed Muhammad 18
Affiliations
Affiliations
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia; Department of Public Health and Nutrition, The University of Haripur, Haripur 22610, Pakistan. Electronic address: arabaan@gmail.com.
- Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia; Pharmacy Practice and Science Department, College of Pharmacy, University of Arizona, Tucson, AZ, USA.
- Department of Microbiology, Faculty of Medicine, Kuwait University, Safat 13110, Kuwait; Microbiology Unit, Department of Laboratories, Farwania Hospital, Farwania 85000, Kuwait.
- Research Center, Almoosa Specialist Hospital, Al-Ahsa 36342, Saudi Arabia; College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia; School of Nursing, Wollongong University, Wollongong, NSW 2522, Australia; Nursing Department, Prince Sultan Military College of Health Sciences, Dhahran 33048, Saudi Arabia.
- Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 31982, Saudi Arabia.
- Pediatric Department, Abqaiq General Hospital, First Eastern Health Cluster, Abqaiq 33261, Saudi Arabia.
- Clinical Laboratory Science Department, Mohammed Al-Mana College for Medical Sciences, Dammam 34222, Saudi Arabia.
- Infectious Disease Department, King Saud Medical City, Riyadh 7790, Saudi Arabia.
- Infection Prevention and Control, Eastern Health Cluster, Dammam 32253, Saudi Arabia.
- Sheikh Khalifa Medical City, Abu Dhabi Health Services Company (SEHA), Abu Dhabi, 51900, United Arab Emirates; College of Medicine and Health Science, Khalifa University, Abu Dhabi, 127788, United Arab Emirates.
- Molecular Diagnostic Laboratory, King Fahd Military Medical Complex, Dhahran 31932, Saudi Arabia.
- Infectious Disease Unit, Specialty Internal Medicine, King Fahd Military Medical Complex, Dhahran 31932, Saudi Arabia.
- Infectious Diseases Section, Medical Specialties Department, King Fahad Medical City, Riyadh, Saudi Arabia.
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia; Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.
- Medical Microbiology Department, Security Forces Hospital Programme, Dammam 32314, Saudi Arabia.
- Department of Community Medicine and Health Care for Pilgrims, Faculty of Medicine, Umm Al-Qura University, Makkah 21955, Saudi Arabia.
- Department of Microbiology, The University of Haripur, Haripur 22610, Pakistan.
- Department of Microbiology, The University of Haripur, Haripur 22610, Pakistan. Electronic address: javed.muhammad@uoh.edu.pk.
Abstract
In recent years, we are facing the challenge of drug resistance emergence in fungi. The availability of limited antifungals and development of multi-drug resistance in fungal pathogens has become a serious concern in the past years in the health sector. Although several cellular, molecular, and genetic mechanisms have been proposed to explain the drug resistance mechanism in fungi, but a complete understanding of the molecular and genetic mechanisms is still lacking. Besides the genetic mechanism, epigenetic mechanisms are pivotal in the fungal lifecycle and disease biology. However, very little is understood about the role of epigenetic mechanisms in the emergence of multi-drug resistance in fungi, especially in Candida auris (C. auris). The current narrative review summaries the clinical characteristics, genomic organization, and molecular/genetic/epigenetic mechanisms underlying the emergence of drug resistance in C. auris. A very few studies have attempted to evaluate the role of epigenetic mechanisms in C. auris. Furthermore, advanced genetic tools such as the CRISP-Cas9 system can be utilized to elucidate the epigenetic mechanisms and their role in the emergence of multi-drug resistance in C. auris.
Keywords: Candida auris; Drug resistance; Epigenetic; Fungi; Genetic.
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