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Is the superbug fungus really so scary? A systematic review and meta-analysis of global epidemiology and mortality of Candida auris
Open accessAbstract
Background: Candida auris is a new pathogen called “superbug fungus” which caused panic worldwide. There are no large-scale epidemiology studies by now, therefore a systematic review and meta-analysis was undertaken to determine the epidemic situation, drug resistance patterns and mortality of C. auris . Methods: We systematically searched studies on the clinical report of Candida auris in Pubmed, Embase and Cochrane databases until October 6, 2019. A standardized form was used for data collection, and then statics was performed with STATA11.0. Results: It showed that more than 4733 cases of C. auris were reported in over 33 countries, with more cases in South Africa, United States of America, India, Spain, United Kingdom, South Korea, Colombia and Pakistan. C. auirs exhibited a decrease in case count after 2016. Clade I and III were the most prevalent clades with more cases reported and wider geographical distribution. Blood stream infection was observed in 32% of the cases, which varied depending on the clades. Resistance to fluconazole, amphotericin B, caspofungin, micafungin and anidulafungin in C. auris were 91, 12, 12.1, 0.8 and 1.1%. The overall mortality of C. auris infection was 39%. Furthermore, subgroup analyses showed that mortality was higher in bloodstream infections (45%), and lower in Europe (20%). Conclusions: Over 4000 cases of C. auris were reported in at least 33 countries, which showed high resistance to fluconazole, moderate resistance to amphotericin B and caspofungin, high sensitivity to micafungin and anidulafungin. The crude mortality for BSI of C. auris was 45% which was similar to some drug-resistant bacteria previously reported. In conclusion, C. auris displayed similar characteristics to some drug resistance organisms. This study depicts several issues of C. auris that are most concerned, and is of great significance for the clinical management.
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“C. auris can show clinical resistance to all classes of antifungal drugs, including echinocandins that are usually recommended as first-line therapies for invasive candidiasis.”
From Transcriptomics and Phenotyping Define Genetic Signatures Associated with Echinocandin Resistance in Candida auris (2022) · cites this paper as [15]
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Metadata
- Authors
- Chen, J., Tian, S., Han, X., Chu, Y., Wang, Q., Zhou, B., & Shang, H.
- Affiliations
- First Hospital of China Medical University (CN)
- Corresponding author
- Shang, Hong
- Venue
- BMC Infectious Diseases
- Published
- 2020-11-11
- Volume
- 20
- Issue
- 1
- Pages
- 827-827
- ISSN
- 1471-2334 (ISSN-L)
- PMC
- PMC7656719
- OpenAlex
- W3102866798
- Cited by
- 159
- References
- 79
- Citations by year
- 2026: 36 · 2025: 26 · 2024: 30 · 2023: 38 · 2022: 20 · 2021: 9
- FWCI
- 0.79
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Infectious Diseases (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Laboratory medicine innovation unit, Chinese Academy of Medical Sciences (2019RU017)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Life Sciences › Immunology and Microbiology › Microbiology › Yeasts and Rust Fungi Studies
- Health Sciences › Medicine › Infectious Diseases › Fungal Infections and Studies
- Keywords
- Candida auris, fungemia, antifungal resistance, fluconazole resistance, amphotericin B resistance, caspofungin resistance, micafungin, anidulafungin, global epidemiology, mortality, emerging fungal pathogens
- MeSH terms
- Caspofungin, Micafungin, Anidulafungin, Amphotericin B, Antifungal Agents, Candida, Candidiasis, Humans, Fluconazole, Prevalence, Drug Resistance, Multiple, Fungal
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