Is the superbug fungus really so scary? A systematic review and meta-analysis of global epidemiology and mortality of Candida auris

Chen, Jingjing; Song, Tian; Han, Xiaoxu; Yunzhuo, Chu; Wang, Qihui; Zhou, Baosen; Shang, Hong

doi:10.1186/s12879-020-05543-0

Cited by 72 publications

(68 citation statements)

References 77 publications

(22 reference statements)

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“…While the majority of identified C. auris isolates display intrinsic resistance to azoles such as fluconazole, susceptibilities to other antifungals strongly vary among clades. Recent studies demonstrated that clade II isolates (East Asian clade) show the highest degree of antifungal susceptibilities, while clade I strains (South Asian clade) show the lowest susceptibility (Arendrup et al, 2017;Szekely et al, 2019;Chen et al, 2020;Chow et al, 2020). In line with this, resistance to the polyene amphotericin B (AmB) was mainly detected in clade I and clade IV (South America clade) isolates (Chow et al, 2020).…”

Section: Introductionmentioning

confidence: 83%

Transcriptome Signatures Predict Phenotypic Variations of Candida auris

Jenull

Tscherner

Kashko

et al. 2021

Front. Cell. Infect. Microbiol.

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Health care facilities are facing serious threats by the recently emerging human fungal pathogen Candida auris owing to its pronounced antifungal multidrug resistance and poor diagnostic tools. Distinct C. auris clades evolved seemingly simultaneously at independent geographical locations and display both genetic and phenotypic diversity. Although comparative genomics and phenotypic profiling studies are increasing, we still lack mechanistic knowledge about the C. auris species diversification and clinical heterogeneity. Since gene expression variability impacts phenotypic plasticity, we aimed to characterize transcriptomic signatures of C. auris patient isolates with distinct antifungal susceptibility profiles in this study. First, we employed an antifungal susceptibility screening of clinical C. auris isolates to identify divergent intra-clade responses to antifungal treatments. Interestingly, comparative transcriptional profiling reveals large gene expression differences between clade I isolates and one clade II strain, irrespective of their antifungal susceptibilities. However, comparisons at the clade levels demonstrate that minor changes in gene expression suffice to drive divergent drug responses. Finally, we functionally validate transcriptional signatures reflecting phenotypic divergence of clinical isolates. Thus, our results suggest that large-scale transcriptional profiling allows for predicting phenotypic diversities of patient isolates, which may help choosing suitable antifungal therapies of multidrug-resistant C. auris.

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Section: Introductionmentioning

confidence: 83%

Transcriptome Signatures Predict Phenotypic Variations of Candida auris

Jenull

Tscherner

Kashko

et al. 2021

Front. Cell. Infect. Microbiol.

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“…As of 15 February 2021, 47 countries have reported a single case or cluster of cases or outbreaks of C. auris infections, according to the Center for Disease Control and Prevention (CDC) of the United States of America ( accessed on 31 March 2021). The epidemiology of invasive C. auris infections has seen dramatic changes, as the sporadic invasive infections from the early years have now been replaced by nosocomial outbreaks that are being reported more frequently and appear to involve an increasing number of patients [ 29 , 30 , 31 , 32 , 37 , 38 , 39 ]. Studies have shown that once C. auris is introduced into a healthcare facility, it spreads rapidly among susceptible patients [ 40 , 41 ].…”

Section: Epidemiology Of C Auris Infectionsmentioning

confidence: 99%

“…C. auris has several unique characteristics, which include its ability to persist, despite the use of common disinfectants, and remain viable for several months, likely due to biofilm formation on plastic surfaces, the hospital environment, and medical devices [ 68 , 69 , 70 ]. Furthermore, very high rates of resistance to fluconazole and variable susceptibility to other azoles, amphotericin B, and echinocandins make the management of C. auris infections extremely difficult [ 37 , 56 , 57 , 58 , 71 , 72 , 73 ]. Crude mortality rates varying from 0 to 72% have been reported among C. auris -infected patients in different studies [ 29 , 30 , 31 , 32 , 37 , 48 , 52 , 56 , 57 , 58 , 74 ].…”

Section: Epidemiology Of C Auris Infectionsmentioning

confidence: 99%

“…Furthermore, very high rates of resistance to fluconazole and variable susceptibility to other azoles, amphotericin B, and echinocandins make the management of C. auris infections extremely difficult [ 37 , 56 , 57 , 58 , 71 , 72 , 73 ]. Crude mortality rates varying from 0 to 72% have been reported among C. auris -infected patients in different studies [ 29 , 30 , 31 , 32 , 37 , 48 , 52 , 56 , 57 , 58 , 74 ]. C. auris frequently colonizes the axilla, groin, nares, respiratory tract, and urinary tract in hospitalized patients [ 29 , 30 , 31 , 32 , 58 , 75 , 76 , 77 , 78 ].…”

Section: Epidemiology Of C Auris Infectionsmentioning

confidence: 99%

“…An important reason for C. auris to be known as a “superbug” in recent years is its intrinsic resistance to one, more and sometimes to all available antifungal drugs [ 30 , 37 , 62 , 73 ]. Generally, C. auris strains exhibit very high rates of resistance to fluconazole and a variable susceptibility to other azoles, amphotericin B, and echinocandins, which makes the antifungal management of C. auris infections, particularly invasive infections in patients with multiple comorbidities, extremely difficult [ 29 , 30 , 31 , 32 , 39 , 58 , 62 ].…”

Section: Susceptibility Of C Auris To Antifungal Drugsmentioning

confidence: 99%

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Candida auris: Epidemiology, Diagnosis, Pathogenesis, Antifungal Susceptibility, and Infection Control Measures to Combat the Spread of Infections in Healthcare Facilities

Ahmad

Alfouzan

2021

Microorganisms

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Candida auris, a recently recognized, often multidrug-resistant yeast, has become a significant fungal pathogen due to its ability to cause invasive infections and outbreaks in healthcare facilities which have been difficult to control and treat. The extraordinary abilities of C. auris to easily contaminate the environment around colonized patients and persist for long periods have recently resulted in major outbreaks in many countries. C. auris resists elimination by robust cleaning and other decontamination procedures, likely due to the formation of ‘dry’ biofilms. Susceptible hospitalized patients, particularly those with multiple comorbidities in intensive care settings, acquire C. auris rather easily from close contact with C. auris-infected patients, their environment, or the equipment used on colonized patients, often with fatal consequences. This review highlights the lessons learned from recent studies on the epidemiology, diagnosis, pathogenesis, susceptibility, and molecular basis of resistance to antifungal drugs and infection control measures to combat the spread of C. auris infections in healthcare facilities. Particular emphasis is given to interventions aiming to prevent new infections in healthcare facilities, including the screening of susceptible patients for colonization; the cleaning and decontamination of the environment, equipment, and colonized patients; and successful approaches to identify and treat infected patients, particularly during outbreaks.

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