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Cited by 163Antifungal resistance and susceptibilityYeasts and Rust Fungi StudiesFungal Infections and Studies

The DOI matches its Crossref record; 79 of the 79 references it cites were found in a registry or an index.

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

Open access
Chen, Jingjing, Tian, Sufei, Han, Xiaoxu, Chu, Yunzhuo, Wang, Qihui, Zhou, Baosen, Shang, Hong·2020·BMC Infectious Diseases
DOI 10.1186/s12879-020-05543-0PMC PMC7656719
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Abstract

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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Crossref · 10.1186/s12879-020-05543-0

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Fig. 1 Global reported cases of C. auris by country (adapted from Robinson projection map). The reported case count of patients with C. auris and clade(s) in different countries were represented in descending order. An epidemic curve showing case count of C. auris by year was also portrayed based on publication data
Fig. 1 Global reported cases of C. auris by country (adapted from Robinson projection map). The reported case count of patients with C. auris and clade(s) in different countries were represented in descending order. An epidemic curve showing case count of C. auris by year was also portrayed based on publication dataCC BY · PubMed Central
Fig. 2 Forest plot on BSI rate of C. auris (a) and subgroup analysis by clade (b). ES: Effect size
Fig. 2 Forest plot on BSI rate of C. auris (a) and subgroup analysis by clade (b). ES: Effect sizeCC BY · PubMed Central
Fig. 3 Forest plot on the drug resistance of C. auris to fluconazole (a) and amphotericin B (b)
Fig. 3 Forest plot on the drug resistance of C. auris to fluconazole (a) and amphotericin B (b)CC BY · PubMed Central
Fig. 4 Forest plot on the crude mortality of C. auris
Fig. 4 Forest plot on the crude mortality of C. aurisCC BY · PubMed Central

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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
ORCID
Venue
BMC Infectious Diseases
Publisher
Springer Science and Business Media LLC
Published
2020-11-11
Volume
20
Issue
1
Pages
827-827
ISSN
1471-2334 (ISSN-L)
DOI
10.1186/s12879-020-05543-0
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
Licence
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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