{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T01:04:42Z","timestamp":1790298282345,"version":"4.1.0"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T00:00:00Z","timestamp":1746576000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R01DK128805"],"award-info":[{"award-number":["R01DK128805"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015691","name":"Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R01AI177875"],"award-info":[{"award-number":["R01AI177875"]}],"id":[{"id":"10.13039\/100015691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015691","name":"Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R21AI71742"],"award-info":[{"award-number":["R21AI71742"]}],"id":[{"id":"10.13039\/100015691","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Open Philanthropy"},{"DOI":"10.13039\/100012617","name":"Arthur J. Schmitt Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012617","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012463","name":"Eck Institute for Global Health, University of Notre Dame","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012463","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plospathogens.org"],"crossmark-restriction":false},"short-container-title":["PLoS Pathog"],"abstract":"<jats:p>Urinary tract infections (UTIs) are one of the most common infections, with a subgroup of these infections, catheter-associated UTIs (CAUTIs), accounting for 40% of nosocomial infections. While the majority of CAUTI pathogens are bacterial, the second most common pathogen is the fungus <jats:italic>Candida albicans.<\/jats:italic> However, in recent years, <jats:italic>Candida auris<\/jats:italic> has increasingly been isolated from urine, indicating <jats:italic>C. auris\u2019<\/jats:italic> potential as a urinary pathogen. <jats:italic>C. auris<\/jats:italic> has rapidly emerged as a human pathogen worldwide, becoming a serious health threat. This is of great concern due to its antifungal resistance, adherence to inanimate surfaces, high mortality rates, and the extensive knowledge gap regarding <jats:italic>C. auris\u2019<\/jats:italic> prevalence and pathophysiology. To understand whether <jats:italic>C. auris<\/jats:italic> is prevalent in the urinary tract, we analyzed 12,996 <jats:italic>C. auris<\/jats:italic> clinical strains and their frequency related to urine and urinary catheters. We identified urine as the second most common <jats:italic>C. auris<\/jats:italic> isolation source in the United States and the third most common worldwide. Anecdotally, <jats:italic>C. auris<\/jats:italic> urine isolates are often associated with urinary catheters and high mortality rates. Furthermore, there has been an early indication of urinary isolates developing echinocandin resistance. With the increasing incidence of uropathogenic <jats:italic>C. auris<\/jats:italic>, it is critical to have an in-depth understanding of <jats:italic>C. auris<\/jats:italic> pathogenesis in the urinary tract to effectively prevent and treat these infections.<\/jats:p>","DOI":"10.1371\/journal.ppat.1013138","type":"journal-article","created":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T20:14:10Z","timestamp":1746648850000},"page":"e1013138","update-policy":"https:\/\/doi.org\/10.1371\/journal.ppat.corrections_policy","source":"Crossref","is-referenced-by-count":22,"title":["Candida auris is emerging as a prevalent urinary pathogen"],"prefix":"10.1371","volume":"21","author":[{"given":"Alyssa Ann","family":"La Bella","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe Hiram","family":"Santiago-Tirado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4610-4246","authenticated-orcid":true,"given":"Ana Lidia","family":"Flores-Mireles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,5,7]]},"reference":[{"issue":"20","key":"ppat.1013138.ref001","doi-asserted-by":"crossref","first-page":"1924","DOI":"10.1056\/NEJMra2402635","article-title":"Candida auris infections","volume":"391","author":"MS Lionakis","year":"2024","journal-title":"N Engl J Med"},{"key":"ppat.1013138.ref002","volume-title":"Candida auris in healthcare settings \u2013 Europe \u2013 first update","author":"Control. ECfDPa","year":"2018"},{"issue":"3","key":"ppat.1013138.ref003","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1310\/sci2503-228","article-title":"Pathophysiology, treatment, and prevention of catheter-associated urinary tract infection","volume":"25","author":"A Flores-Mireles","year":"2019","journal-title":"Top Spinal Cord Inj Rehabil"},{"issue":"5","key":"ppat.1013138.ref004","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1086\/675718","article-title":"Strategies to prevent catheter-associated urinary tract infections in acute care hospitals: 2014 update","volume":"35","author":"E Lo","year":"2014","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"6","key":"ppat.1013138.ref005","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1017\/ice.2023.283","article-title":"The next frontier of healthcare-associated infection (HAI) surveillance metrics: beyond device-associated infections","volume":"45","author":"SD Advani","year":"2024","journal-title":"Infect Control Hosp Epidemiol"},{"key":"ppat.1013138.ref006","doi-asserted-by":"crossref","first-page":"104555","DOI":"10.1016\/j.ijnurstu.2023.104555","article-title":"Prevalence of indwelling urinary catheters in nursing home residents: systematic review","volume":"145","author":"J Czwikla","year":"2023","journal-title":"Int J Nurs Stud"},{"issue":"5","key":"ppat.1013138.ref007","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1111\/j.1532-5415.2008.01675.x","article-title":"Use of urinary collection devices in skilled nursing facilities in five states","volume":"56","author":"MAM Rogers","year":"2008","journal-title":"J Am Geriatr Soc"},{"issue":"6","key":"ppat.1013138.ref008","doi-asserted-by":"crossref","first-page":"889","DOI":"10.2217\/ahe.11.80","article-title":"Common infections in nursing homes: a review of current issues and challenges","volume":"7","author":"A Montoya","year":"2011","journal-title":"Aging health"},{"issue":"5","key":"ppat.1013138.ref009","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1017\/ice.2023.215","article-title":"Incidence and risk factors for catheter-associated urinary tract infection in 623 intensive care units throughout 37 Asian, African, Eastern European, Latin American, and Middle Eastern nations: a multinational prospective research of INICC","volume":"45","author":"VD Rosenthal","year":"2024","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"9","key":"ppat.1013138.ref010","doi-asserted-by":"crossref","DOI":"10.1126\/sciadv.ade7689","article-title":"The catheterized bladder environment promotes Efg1- and Als1-dependent Candida albicans infection","volume":"9","author":"AA La Bella","year":"2023","journal-title":"Sci Adv"},{"issue":"10","key":"ppat.1013138.ref011","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1111\/iju.12200","article-title":"Diagnosis and management for urosepsis","volume":"20","author":"FME Wagenlehner","year":"2013","journal-title":"Int J Urol"},{"key":"ppat.1013138.ref012","author":"Prevention CfDCa","year":"2024"},{"issue":"10","key":"ppat.1013138.ref013","article-title":"Emerging healthcare threat Candida auris: a prevalence study from a rural tertiary referral centre in Western India","volume":"16","author":"SB Tajane","year":"2024","journal-title":"Cureus"},{"issue":"9","key":"ppat.1013138.ref014","article-title":"Mortality and associated risk factors in patients with Candida auris: insights from a Tertiary Care Hospital in Bahrain","volume":"16","author":"R Alagha","year":"2024","journal-title":"Cureus"},{"key":"ppat.1013138.ref015","doi-asserted-by":"crossref","first-page":"1033707","DOI":"10.3389\/fcimb.2023.1033707","article-title":"Colonized patients by Candida auris: third and largest outbreak in Brazil and impact of biofilm formation","volume":"13","author":"CC de Melo","year":"2023","journal-title":"Front Cell Infect Microbiol"},{"issue":"24","key":"ppat.1013138.ref016","doi-asserted-by":"crossref","first-page":"3150","DOI":"10.3390\/healthcare11243150","article-title":"Description of Candida auris occurrence in a tertiary health institution in Riyadh, Saudi Arabia","volume":"11","author":"FS Alshahrani","year":"2023","journal-title":"Healthcare (Basel)"},{"issue":"2","key":"ppat.1013138.ref017","doi-asserted-by":"crossref","first-page":"157","DOI":"10.3390\/pathogens10020157","article-title":"First Candida auris outbreak during a COVID-19 pandemic in a Tertiary-Care Center in Lebanon","volume":"10","author":"F Allaw","year":"2021","journal-title":"Pathogens"},{"issue":"12","key":"ppat.1013138.ref018","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1111\/myc.13655","article-title":"Whole genome sequencing analysis demonstrates therapy-induced echinocandin resistance in Candida auris isolates","volume":"66","author":"B Spruijtenburg","year":"2023","journal-title":"Mycoses"},{"issue":"4","key":"ppat.1013138.ref019","doi-asserted-by":"crossref","first-page":"307","DOI":"10.3390\/jof6040307","article-title":"Molecular epidemiology of Candida auris outbreak in a Major Secondary-Care Hospital in Kuwait","volume":"6","author":"W Alfouzan","year":"2020","journal-title":"J Fungi (Basel)"},{"key":"ppat.1013138.ref020","doi-asserted-by":"crossref","first-page":"1244358","DOI":"10.3389\/fpubh.2023.1244358","article-title":"Emergence of highly resistant Candida auris in the United Arab Emirates: a retrospective analysis of evolving national trends","volume":"11","author":"J Thomsen","year":"2024","journal-title":"Front Public Health"},{"issue":"7","key":"ppat.1013138.ref021","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofz262","article-title":"Development of high-level echinocandin resistance in a patient with recurrent Candida auris candidemia secondary to chronic candiduria","volume":"6","author":"MJ Biagi","year":"2019","journal-title":"Open Forum Infect Dis"},{"issue":"1","key":"ppat.1013138.ref022","doi-asserted-by":"crossref","first-page":"2377584","DOI":"10.1080\/22221751.2024.2377584","article-title":"Evolutionary accumulation of FKS1 mutations from clinical echinocandin-resistant Candida auris","volume":"13","author":"S Tian","year":"2024","journal-title":"Emerg Microbes Infect"},{"issue":"1","key":"ppat.1013138.ref023","doi-asserted-by":"crossref","DOI":"10.1128\/CMR.00029-17","article-title":"Candida auris: a review of the literature","volume":"31","author":"A Jeffery-Smith","year":"2017","journal-title":"Clin Microbiol Rev"},{"key":"ppat.1013138.ref024","article-title":"Microbiological characteristics and drug resistance rates of Candida auris isolates in Japan","author":"M Abe","year":"2025","journal-title":"Jpn J Infect 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Anatomy, abdomen and pelvis: bladder. StatPearls. Treasure Island (FL) ineligible companies. Disclosure: Sajedur Rahman declares no relevant financial relationships with ineligible companies. Disclosure: Stephen Leslie declares no relevant financial relationships with ineligible companies. 2025."},{"issue":"4","key":"ppat.1013138.ref027","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1038\/ki.2012.467","article-title":"The antibacterial shield of the human urinary tract","volume":"83","author":"M Zasloff","year":"2013","journal-title":"Kidney Int"},{"key":"ppat.1013138.ref028","author":"AA La Bella","year":"2025"}],"container-title":["PLOS Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.ppat.1013138","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T20:14:15Z","timestamp":1746648855000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.ppat.1013138"}},"subtitle":[],"editor":[{"given":"Mary Ann","family":"Jabra-Rizk,","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,5,7]]},"references-count":28,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5,7]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.ppat.1013138","relation":{},"ISSN":["1553-7374"],"issn-type":[{"value":"1553-7374","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,7]]}}}