Retrospective analysis of the clinical characteristics of Candida auris infection worldwide from 2009 to 2020
Open accessPublished version of a preprint
Abstract
Introduction: Candida auris is an emerging multidrug-resistant fungus that may cause infections with a high mortality rate. The first case of C. auris infection was reported in 2009 and infections have been reported in 44 countries. The fungus now represents a major global public health threat. We analyzed cases from the emergence of C. auris infections up until the end of 2020. It is hoped that the results of this analysis will raise awareness in scientists to promote protection and control research pertaining to this pathogen. Methods: PubMed and Web of Science databases were searched for all papers related to C. auris infections up until December 31, 2020. We sorted and organized these data into the following categories: date of publication, patient age and sex, underlying diseases, risk factors for infection, patient mortality information, drug sensitivity information of C. auris isolates, and genetic classification. The χ 2 test was used to screen for factors that may affect patient mortality. Results: A total of 912 patients were included in the analysis. There’s a higher proportion of men and a high proportion of patients were premature babies and elderly people. The proportions of patients with underlying diseases such as diabetes, kidney disease, trauma, and ear disease were also high. More than half of patients had a history of central venous catheter use and a history of broad-spectrum antibiotic use. The χ 2 test revealed that only kidney disease ( P < 0.05) was an important risk factor for mortality in C. auris- infected patients. Conclusions: A comprehensive understanding of C. auris was achieved following this retrospective analysis, including the characteristics of C. auris -infected patients. In recent years, increasing numbers of multidrug-resistant C. auris isolates have been identified, and the high mortality rates associated with infection merit greater attention from the medical world.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Additional clinical conditions associated with C. auris colonization and/or systemic infection include chronic kidney disease, hemodialysis, malignancy, central venous or urinary catheterization, and total parenteral nutrition, mirroring known risk factors for infections by other Candida species.
“Additional clinical conditions associated with C. auris colonization and/or systemic infection include chronic kidney disease, hemodialysis, malignancy, central venous or urinary catheterization, and total parenteral nutrition, mirroring known risk factors for infections by other Candida species [45,46,59].”
From Host–Candida auris interactions in the skin (2026) · cites this paper as [46]
Split into 2 atoms — 0 confirmed, 1 partially supported, 1 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredC. auris skin colonization frequently occurs in patients recently exposed to prolonged courses of broad-spectrum antibiotics, particularly carbapenems and vancomycin, with 43.3% of colonized patients treated with carbapenems, and 41.7% with vancomycin.
“C. auris skin colonization frequently occurs in patients recently exposed to prolonged courses of broad-spectrum antibiotics, particularly carbapenems and vancomycin, with 43.3% of colonized patients treated with carbapenems, and 41.7% with vancomycin [40–43,45–47].”
From Host–Candida auris interactions in the skin (2026) · cites this paper as [46]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Hosmer, D. W., Lemeshow, S., & Sturdivant, R. X. (2013) · Wiley Series in Probability and Statistics · doi:10.1002/9781118548387 · Cited by 13,861 · see citing works
A simulation study of the number of events per variable in logistic regression analysis
Peduzzi, P., Concato, J., Kemper, E., Holford, T. R., & Feinstein, A. R. (1996) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(96)00236-3 · Cited by 9,655 · see citing works
Diabetic Kidney Disease: Challenges, Progress, and Possibilities
Alicic, R. Z., Rooney, M. T., & Tuttle, K. R. (2017) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.11491116 · Cited by 2,898 · see citing works
Chowdhary, A., Sharma, C., & Meis, J. F. (2017) · PLOS Pathogens · doi:10.1371/journal.ppat.1006290 · Cited by 750 · see citing works
Global epidemiology of emerging Candida auris
Rhodes, J., & Fisher, M. C. (2019) · Current Opinion in Microbiology · doi:10.1016/j.mib.2019.05.008 · Cited by 315 · see citing works
Candida auris: Disinfectants and Implications for Infection Control
Ku, T. S. N., Walraven, C. J., & Lee, S. A. (2018) · Frontiers in Microbiology · doi:10.3389/fmicb.2018.00726 · Cited by 177 · see citing works
Healey, K. R., Kordalewska, M., Jiménez Ortigosa, C., Singh, A., Berrío, I., Chowdhary, A., & Perlin, D. S. (2018) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.01427-18 · Cited by 165 · see citing works
Hou, X., Lee, A., Jiménez-Ortigosa, C., Kordalewska, M., Perlin, D. S., & Zhao, Y. (2019) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.01811-18 · Cited by 66 · see citing works
Flagged first, then by citations
Research works printed but not linked: 35
- Agrawal P. B. Narang A. Kumar P. (1996). Fluconazole. Indian J. Pediatr. 63 775– 780. 10.1007/BF02730928 10830059 · DOI
- Biswal M. Rudramurthy S. M. Jain N. Shamanth A. S. Sharma D. Jain K. (2017). Controlling a possible outbreak of Candida auris infection: lessons learnt from multiple interventions. J. Hosp. Infect. 97 363– 370. 10.1016/j.jhin.2017.09.009 28939316 · DOI
- Calvo B. Melo A. S. A. Perozo-Mena A. Hernandez M. Francisco E. C. Hagen F. (2016). First report of Candida auris in America: clinical and microbiological aspects of 18 episodes of candidemia. J. Infect. 73 369– 374. 10.1016/j.jinf.2016.07.008 27452195 · DOI
- Chowdhary A. Prakash A. Sharma C. Kordalewska M. Kumar A. Sarma S. (2018). A multicentre study of antifungal susceptibility patterns among 350 Candida auris isolates (2009-17) in India: role of the ERG11 and FKS1 genes in azole and echinocandin resistance. J. Antimicrob, Chemother. 73 891– 899. 10.1093/jac/dkx480 29325167 · DOI · Paper page
- Chowdhary A. Sharma C. Duggal S. Agarwal K. Prakash A. Singh P. K. (2013). New clonal strain of Candida auris, Delhi, India. Emerg. Infect. Dis. 19 1670– 1673. 10.3201/eid1910.130393 24048006 PMC3810747 · DOI
- Chowdhary A. Voss A. Meis J. F. (2016). Multidrug-resistant Candida auris: ‘new kid on the block’ in hospital-associated infections? J. Hosp. Infect. 94 209– 212. 10.1016/j.jhin.2016.08.004 27634564 · DOI · Paper page
- Collister D. Rigatto C. Tangri N. (2017). Anemia management in chronic kidney disease and dialysis: a narrative review. Curr. Opin. Nephrol. Hypertens. 26 214– 218. 10.1097/MNH.0000000000000317 28306566 · DOI
- Cortegiani A. Misseri G. Giarratano A. Bassetti M. Eyre D. (2019). The global challenge of Candida auris in the intensive care unit. Crit. Care 23: 150. 10.1186/s13054-019-2449-y 31046836 PMC6495550 · DOI
- Emara M. Ahmad S. Khan Z. Joseph L. Al-Obaid I. Purohit P. (2015). Candida auris candidemia in Kuwait, 2014. Emerg. Infect. Dis. 21 1091– 1092. 10.3201/eid2106.150270 25989098 PMC4451886 · DOI
- Farina C. Manso E. Andreoni S. Conte M. Fazii P. Lombardi G. (2011). Interlaboratory evaluation of VITEK2 system and Sensititre YeastOne® for antifungal susceptibility testing of yeasts isolated from blood cultures against four antifungal agents. New Microbiol. 34 195– 201. 21617832
- Jeffery-Smith A. Taori S. K. Schelenz S. Jeffery K. Johnson E. M. Borman A. (2018). Candida auris: a review of the literature. Clin. Microbiol. Rev. 31: e00029-17. 10.1128/CMR.00029-17 29142078 PMC5740969 · DOI
- Kathuria S. Singh P. K. Sharma C. Prakash A. Masih A. Kumar A. (2015). Multidrug-Resistant Candida auris misidentified as Candida haemulonii: characterization by matrix-assisted laser desorption Ionization–Time of flight mass spectrometry and DNA sequencing and its antifungal susceptibility profile variability by Vitek 2, CLSI Broth microdilution, and etest method. J. Clin. Microbiol. 53 1823– 1830. 10.1128/JCM.00367-15 25809970 PMC4432077 · DOI
- Kordalewska M. Lee A. Park S. Berrio I. Chowdhary A. Zhao Y. (2018). Understanding echinocandin resistance in the emerging pathogen Candida auris. Antimicrob. Agents Chemother. 62: e00238-18. 10.1128/AAC.00238-18 29632013 PMC5971591 · DOI · Paper page
- Lara H. H. Ixtepan-Turrent L. Jose Yacaman M. Lopez-Ribot J. (2020). Inhibition of Candida auris biofilm formation on medical and environmental surfaces by silver nanoparticles. Acs Appl. Mater. Inter. 12 21183– 21191. 10.1021/acsami.9b20708 31944650 PMC8243355 · DOI · Paper page
- Larkin E. Hager C. Chandra J. Mukherjee P. K. Retuerto M. Salem I. (2017). The emerging pathogen Candida auris: growth phenotype, virulence factors, activity of antifungals, and effect of SCY-078, a novel glucan synthesis inhibitor, on growth morphology and biofilm formation. Antimicrob. Agents Chemother. 61: e02396-16. 10.1128/AAC.02396-16 28223375 PMC5404565 · DOI · Paper page
- Lockhart S. R. Etienne K. A. Vallabhaneni S. Farooqi J. Chowdhary A. Govender N. P. (2016). Simultaneous emergence of multidrug-resistant Candida auris on 3 continents confirmed by whole-genome sequencing and epidemiological analyses. Clin. Infect. Dis. 64 134– 140. 10.1093/cid/ciw691 27988485 PMC5215215 · DOI · Paper page
- Madder H. Moir I. Moroney R. Butcher L. Newnham R. Sunderland M. (2017). Multiuse patient monitoring equipment as a risk factor for acquisition of Candida auris. bioRxiv [Preprint]. 10.1101/149054 · DOI
- Meis J. F. Chowdhary A. (2018). Candida auris: a global fungal public health threat. Lancet Infect. Dis. 18 1298– 1299. 10.1016/S1473-3099(18)30609-1 30293876 · DOI
- Mejia-Chew C. O’halloran J. A. Olsen M. A. Stwalley D. Kronen R. Lin C. (2019). Effect of infectious disease consultation on mortality and treatment of patients with candida bloodstream infections: a retrospective, cohort study. Lancet Infect. Dis. 19 1336– 1344. 10.1016/S1473-3099(19)30405-0 31562024 PMC7014922 · DOI
- Muñoz J. F. Gade L. Chow N. A. Loparev V. N. Juieng P. Berkow E. L. (2018). Genomic insights into multidrug-resistance, mating and virulence in Candida auris and related emerging species. Nat. Commun. 9: 5346. 10.1038/s41467-018-07779-6 30559369 PMC6297351 · DOI · Paper page
- Nancy A. C. Theun De G. Hamid B. Abastabar M. Chiller T. M. Meis J. F. (2019). Potential fifth clade of Candida auris, Iran, 2018. Emerg. Infect. Dis. 25 1780– 1781. 10.3201/eid2509.190686 31310230 PMC6711235 · DOI · Paper page
- Navalkele B. D. Revankar S. Chandrasekar P. (2017). Candida auris: a worrisome, globally emerging pathogen. Expert Rev. Anti Infect. 15 819– 827. 10.1080/14787210.2017.1364992 28783385 · DOI
- Oh B. J. Shin J. H. Kim M. N. Sung H. Lee K. Joo M. Y. (2011). Biofilm formation and genotyping of Candida haemulonii, Candida pseudohaemulonii, and a proposed new species (Candida auris) isolates from Korea. Med. Mycol. 49 98– 102. 10.3109/13693786.2010.493563 20560864 · DOI
- Ostrowsky B. Greenko J. Adams E. Quinn M. O’Brien B. Chaturvedi V. (2020). Candida auris Isolates resistant to three classes of antifungal medications - New York, 2019. MMWR Morb. Mortal. Wkly. Rep. 69 6– 9. 10.15585/mmwr.mm6901a2 31917780 PMC6973342 · DOI
- Palazón-Bru A. Tomás-Rodríguez M. I. López-Cascales M. T. Folgado-de la Rosa D. M. Gil-Guillén V. F. (2017). Multivariate ordered logistic regression models: dealing with the model-building strategy. J. Pediatr. Adol. Gynec. 30: 664. 10.1016/j.jpag.2017.06.006 28663155 · DOI
- Park J. Y. Bradley N. Brooks S. Burney S. Wassner C. (2019). Management of patients with Candida auris fungemia at community hospital, Brooklyn, New York, USA, 2016–2018. Emerg. Infect. Dis. 25 601– 602. 10.3201/eid2503.180927 30789336 PMC6390749 · DOI
- Rhee C. M. Ahmadi S. F. Kovesdy C. P. Kalantar-Zadeh K. (2018). Low-protein diet for conservative management of chronic kidney disease: a systematic review and meta-analysis of controlled trials. J. Cachexia Sarcopenia Muscle 9 235– 245. 10.1002/jcsm.12264 29094800 PMC5879959 · DOI
- Rhodes J. Abdolrasouli A. Farrer R. A. Cuomo C. A. Aanensen D. M. Armstrong-James D. (2018). Genomic epidemiology of the UK outbreak of the emerging human fungal pathogen Candida auris. Emerg. Microbes Infect. 7: 43. 10.1038/s41426-018-0045-x 29593275 PMC5874254 · DOI · Paper page
- Rindidzani E. M. Craig C. Sharona S. Govender N. P. (2014). Candida auris–Associated Candidemia, South Africa. Emerg. Infect. Dis. 20 1250– 1251. 10.3201/eid2007.131765 24963796 PMC4073876 · DOI · Paper page
- Rybak J. M. Doorley L. A. Nishimoto A. T. Barker K. S. Palmer G. E. Rogers P. D. (2019). Abrogation of triazole resistance upon deletion of CDR1 in a clinical Isolate of Candida auris. Antimicrob. Agents Chemother. 63: e00057-19. 10.1128/AAC.00057-19 30718246 PMC6437491 · DOI · Paper page
- Satoh K. Makimura K. Hasumi Y. Nishiyama Y. Uchida K. Yamaguchi H. (2009). Candida auris sp. nov., a novel ascomycetous yeast isolated from the external ear canal of an inpatient in a Japanese hospital. Microbiol. Immunol. 53 41– 44. 10.1111/j.1348-0421.2008.00083.x 19161556 · DOI · Paper page
- Shaukat A. Al Ansari N. Al Wali W. Karic E. El Madhoun I. Mitwally H. (2020). Experience of treating Candida auris cases at a general hospital in the state of Qatar. IDCases 23: e01007. 10.1016/j.idcr.2020.e01007 33299794 PMC7702000 · DOI
- Tan J. Liu Z. Sun Y. Yang L. Gao L. (2019). Inhibitory effects of photodynamic inactivation on planktonic cells and biofilms of Candida auris. Mycopathologia 184 525– 531. 10.1007/s11046-019-00352-9 31230199 · DOI
- Vatanshenassan M. Boekhout T. Meis J. F. Berman J. Chowdhary A. Ben-Ami R. (2019). Candida auris identification and rapid antifungal susceptibility testing against echinocandins by MALDI-TOF MS. Front. Cell Infect. Microbiol. 9: 20. 10.3389/fcimb.2019.00020 30834236 PMC6387932 · DOI
- Wang T. Jia Y. Chu B. Liu H. Dong X. Zhang Y. (2019). Nocardiosis in kidney disease patients under immunosuppressive therapy: case report and literature review. Int. J. Med. Sci. 16 838– 844. 10.7150/ijms.32440 31337957 PMC6643105 · DOI
Cited by
Sorted by citations
Candida auris Pan-Drug-Resistant to Four Classes of Antifungal Agents
Jacobs, S. E., Jacobs, J. L., Dennis, E. K., Taimur, S., Rana, M., Patel, D., Gitman, M., Patel, G., Schaefer, S., Iyer, K., et al. (2022) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.00053-22 · Cited by 190 · see citing works
Emerging Antifungal Targets and Strategies
Ivanov, M., Ćirić, A., & Stojković, D. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23052756 · Cited by 160 · see citing works
Sharma, D., Paul, R. A., Rudramurthy, S. M., Kashyap, N., Bhattacharya, S., Soman, R., Shankarnarayan, S. A., Chavan, D., Singh, S., Das, P., et al. (2022) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.01652-21 · Cited by 60 · see citing works
Host–Candida auris interactions in the skin
Thangamani, S., Balakumar, A., Datta, A., Bryak, G., & Lionakis, M. S. (2026) · PLOS Pathogens · doi:10.1371/journal.ppat.1014075 · Cited by 3 · see citing works
- Authors
- Hu, S., Zhu, F., Jiang, W., Wang, Y., Quan, Y., Zhang, G., Gu, F., & Yang, Y.
- Affiliations
- Xuzhou Medical College (CN)
- Hebei University (CN)
- Second Military Medical University (CN)
- Xuzhou Cancer Hospital (CN)
- Corresponding author
- Yang, Ying
- Venue
- Frontiers in Microbiology
- Publisher
- Frontiers Media SA
- Published
- 2021-05-20
- Volume
- 12
- Pages
- 658329-658329
- ISSN
- 1664-302X (ISSN-L)
- PMC
- PMC8173142
- OpenAlex
- W3161498394
- Cited by
- 64
- References
- 8
- Citations by year
- 2026: 18 · 2025: 11 · 2024: 15 · 2023: 11 · 2022: 6 · 2021: 3
- FWCI
- 2.77
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Microbiology (publishedVersion, cc-by)
- medRxiv (acceptedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Ministry of Science and Technology of the People’s Republic of China (2018ZX10101003, 2018ZX10712-001)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Yeasts and Rust Fungi Studies
- Keywords
- Candida auris, candidiasis, multidrug resistance, mortality risk factors, kidney disease, central venous catheters, broad-spectrum antibiotic use, preterm infants, elderly patients, genetic classification, emerging fungal infections
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
