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Candida auris copies its entire genome to survive antifungal treatment, research reveals

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Candida auris copies its entire genome to survive antifungal treatment, research reveals (Unverified, claim 1)

edited by Gaby Clark, reviewed by Robert Egan (Not auto-checked, claim 2)

New research has revealed an unexpected new mechanism through which the killer fungus Candida auris is resisting antifungal drug treatment. (Unverified, claim 3) A team led by the University of Exeter and City St George's, University of London, discovered that the fungus creates multiple versions of its entire genome, including mutating a gene that plays a role in cell wall integrity, called "Crazy-one" (CRZ1). (Unverified, claim 4)

The study is set to appear in Nature Communications and is currently available on the bioRxiv preprint server. (2 claims: 2 Unverified)

Candida auris was only described for the first time in 2008, and its origins remain a mystery. (2 claims: 2 Unverified) Since it emerged, outbreaks have been reported on every continent, in more than 60 countries in total, including the U.K. It has been named a global public health threat and is on the World Health Organization's critical priority fungal pathogens list. (2 claims: 1 Corroborated, 1 Unverified)

Study first author Dr. Hugh Gifford, clinical lecturer at the University of Exeter's MRC Centre for Medical Mycology, is also an intensive care physician. (3 claims: 3 Not auto-checked) He said, "Candida auris is rare in the general population, but it's a deadly threat to patients in intensive care units. (Unverified, claim 14) It clings to patient skin and surrounding equipment and can be transmitted from person to person—it's incredibly hard to eradicate. (Unverified, claim 15) If infection enters a vulnerable patient's bloodstream, there is a 45% death rate. (Unverified, claim 16)

"Outbreaks in intensive care units have been costly and highly disruptive. (Unverified, claim 17) One unit in the U.K. had to close and undergo complete refurbishment to stop the outbreak, while another outbreak was estimated to cost £1 million to control." (Unverified, claim 18)

An accidental discovery of drug survival (Unverified, claim 19)

The research team was initially testing for drug resistance when a researcher accidentally left plates of cells incubating for longer than the required test period. (Unverified, claim 20) The researcher returned to find that cells had unexpectedly grown during this additional time period. (Unverified, claim 21) They were surprised to find that further testing showed the deadly fungus had survived antifungal treatment by creating multiple versions of its own genome, thereby increasing its chances of mutating to evade the drug and survive. (Unverified, claim 22)

Dr. Sarah Murphy, former postdoctoral researcher at City St George's University of London and co-first author, said, "We initially set out to investigate why antifungal drugs weren't working to kill Candida auris, despite laboratory tests showing that they were not resistant and that the drugs should have been effective. (Not auto-checked, claim 23) We were surprised to discover an entirely new mechanism for this fungus to survive—particularly with luck playing a big part in the discovery. (Unverified, claim 24)

"We tested the fungus against very high concentrations of antifungal drugs. We were amazed to find there was a tiny population of cells that appeared over several days and continued to grow. (Unverified, claim 25) Our discovery means we need to now look at new ways of treating people and eradicating this deadly fungus from hospitals."

Expanding further on the finding, Gifford said, "This study had a number of surprising elements. First, we did not identify any of the DNA mutations that we might have expected. (Unverified, claim 26) Antifungal drugs target the enzymes that make cell walls, so that fungi die by shriveling, exploding or not being able to grow. (Unverified, claim 27) Somehow, these fungi had survived antifungal drugs, and we needed to find out why.

"We were surprised to find that surviving cells had made multiple copies of their entire genome. (Unverified, claim 28) This is a trick that other fungi have used in the past, but not one that is well known in C. auris. (Unverified, claim 29) In fact, there were two populations, some growing slowly, others growing more rapidly. (Unverified, claim 30) We call it 'bet-hedging' when a bug uses multiple tactics to increase its chances of developing resistance and evading treatment."

The team found that the more rapidly growing cells contained a wide range of mutations in a gene that has been studied in other organisms for its role in governing cell wall synthesis, called "Crazy-one" (CRZ1). (Unverified, claim 31) Further tests confirmed the rapid growth of CRZ1 mutants and that their cell walls appeared to be unaffected by antifungal drugs. (Unverified, claim 32)

Researchers are now looking at options including the use of antifungal drugs in combination, which is being addressed via the Exeter-led UKRI-funded Fungi-CARE program, also in partnership with colleagues at City St George's. (Unverified, claim 34)

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Every claim 33

  1. 1UnverifiedCandida auris copies its entire genome to survive antifungal treatment, research reveals0 sources

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  2. 2Not auto-checkededited by Gaby Clark, reviewed by Robert Egan0 sources

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  3. 3UnverifiedNew research has revealed an unexpected new mechanism through which the killer fungus Candida auris is resisting antifungal drug treatment.0 sources

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  4. 4UnverifiedA team led by the University of Exeter and City St George's, University of London, discovered that the fungus creates multiple versions of its entire genome, including mutating a gene that plays a role in cell wall integrity, called "Crazy-one" (CRZ1).0 sources

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  5. 5UnverifiedThe study is set to appear in Nature Communications.0 sources

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    part of “The study is set to appear in Nature Communications and is currently available on the bioRxiv preprint server.”

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  6. 6UnverifiedThe study is currently available on the bioRxiv preprint server.0 sources

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    part of “The study is set to appear in Nature Communications and is currently available on the bioRxiv preprint server.”

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  7. 7UnverifiedCandida auris was only described for the first time in 2008.0 sources

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    part of “Candida auris was only described for the first time in 2008, and its origins remain a mystery.”

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  8. 8UnverifiedThe origins of Candida auris remain a mystery.0 sources

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  9. 9CorroboratedCandida auris has been named a global public health threat.1 source

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    part of “Since it emerged, outbreaks have been reported on every continent, in more than 60 countries in total, including the U.K. It has been named a global public health threat and is on the World Health Organization's critical priority fungal pathogens list.”

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    • news.emory.edushowsfound by search
      A new study finds that a natural compound found in many plants inhibits the growth of drug-resistant Candida fungi — including its most virulent species, Candida auris, an emerging global health threat.
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    1. unverified · initial · system
    2. unverified → corroborated · l3_supports · system
  10. 10UnverifiedCandida auris is on the World Health Organization's critical priority fungal pathogens list.0 sources

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    part of “Since it emerged, outbreaks have been reported on every continent, in more than 60 countries in total, including the U.K. It has been named a global public health threat and is on the World Health Organization's critical priority fungal pathogens list.”

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  11. 11Not auto-checkedDr. Hugh Gifford is the study first author.0 sources

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    part of “Study first author Dr. Hugh Gifford, clinical lecturer at the University of Exeter's MRC Centre for Medical Mycology, is also an intensive care physician.”

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  12. 12Not auto-checkedDr. Hugh Gifford is clinical lecturer at the University of Exeter's MRC Centre for Medical Mycology.0 sources

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    Not auto-checked: this sentence names a private individual or small business, so no automated status is given. Evidence only.

    part of “Study first author Dr. Hugh Gifford, clinical lecturer at the University of Exeter's MRC Centre for Medical Mycology, is also an intensive care physician.”

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  13. 13Not auto-checkedDr. Hugh Gifford is also an intensive care physician.0 sources

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    Not auto-checked: this sentence names a private individual or small business, so no automated status is given. Evidence only.

    part of “Study first author Dr. Hugh Gifford, clinical lecturer at the University of Exeter's MRC Centre for Medical Mycology, is also an intensive care physician.”

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  14. 14UnverifiedHe said, "Candida auris is rare in the general population, but it's a deadly threat to patients in intensive care units.0 sources

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  15. 15UnverifiedIt clings to patient skin and surrounding equipment and can be transmitted from person to person—it's incredibly hard to eradicate.0 sources

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  16. 16UnverifiedIf infection enters a vulnerable patient's bloodstream, there is a 45% death rate.0 sources

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  17. 17Unverified"Outbreaks in intensive care units have been costly and highly disruptive.0 sources

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  18. 18UnverifiedOne unit in the U.K. had to close and undergo complete refurbishment to stop the outbreak, while another outbreak was estimated to cost £1 million to control."0 sources

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    • www.nature.comcontextfound by search
      In-silico predicted optical maps of complete genomes were scaled according to the size of sequenced genomes to show identity with Optical maps (Supplementary Figure 1).
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  19. 19UnverifiedAn accidental discovery of drug survival0 sources

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  20. 20UnverifiedThe research team was initially testing for drug resistance when a researcher accidentally left plates of cells incubating for longer than the required test period.0 sources

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  21. 21UnverifiedThe researcher returned to find that cells had unexpectedly grown during this additional time period.0 sources

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    • www.nature.comcontextfound by search
      For RNA extraction, C. auris cells were grown in YPD broth medium (Difco Laboratories, Sparks, MD) at 30 °C in a shaking incubator at 300 rpm.
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  22. 22UnverifiedThey were surprised to find that further testing showed the deadly fungus had survived antifungal treatment by creating multiple versions of its own genome, thereby increasing its chances of mutating to evade the drug and survive.0 sources

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    No independent source we read confirms or contradicts this sentence yet. That is not a finding that it is wrong.

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  23. 23Not auto-checkedDr. Sarah Murphy, former postdoctoral researcher at City St George's University of London and co-first author, said, "We initially set out to investigate why antifungal drugs weren't working to kill Candida auris, despite laboratory tests showing that they were not resistant and that the drugs should have been effective.0 sources

    Report

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  24. 24UnverifiedWe were surprised to discover an entirely new mechanism for this fungus to survive—particularly with luck playing a big part in the discovery.0 sources

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    • www.sciencenews.orgcontextfound by search
      Young Yosemite toads survive winter, then emerge with a deadly fungus
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  25. 25UnverifiedWe were amazed to find there was a tiny population of cells that appeared over several days and continued to grow.0 sources

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  26. 26UnverifiedFirst, we did not identify any of the DNA mutations that we might have expected.0 sources

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  27. 27UnverifiedAntifungal drugs target the enzymes that make cell walls, so that fungi die by shriveling, exploding or not being able to grow.0 sources

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    No independent source we read confirms or contradicts this sentence yet. That is not a finding that it is wrong.

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    • www.nature.comcontextfound by search
      All four species are resistant to antifungal drugs, and the Y132F mutation in the azole drug target ERG11, previously described in C. auris, and was also detected in C. pseudohaemulonii.
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  28. 28Unverified"We were surprised to find that surviving cells had made multiple copies of their entire genome.0 sources

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  29. 29UnverifiedThis is a trick that other fungi have used in the past, but not one that is well known in C. auris.0 sources

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  30. 30UnverifiedIn fact, there were two populations, some growing slowly, others growing more rapidly.0 sources

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  31. 31UnverifiedThe team found that the more rapidly growing cells contained a wide range of mutations in a gene that has been studied in other organisms for its role in governing cell wall synthesis, called "Crazy-one" (CRZ1).0 sources

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  32. 32UnverifiedFurther tests confirmed the rapid growth of CRZ1 mutants and that their cell walls appeared to be unaffected by antifungal drugs.0 sources

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  33. 34UnverifiedResearchers are now looking at options including the use of antifungal drugs in combination, which is being addressed via the Exeter-led UKRI-funded Fungi-CARE program, also in partnership with colleagues at City St George's.0 sources

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  • Combining treatments to counter fungal adaptation Report

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