Retrospective Analysis of the Clinical Characteristics of Candida auris Infection Worldwide From 2009 to 2020

Abstract

IntroductionCandida 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.MethodsPubMed 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 χ2 test was used to screen for factors that may affect patient mortality.ResultsA 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 χ2 test revealed that only kidney disease (P < 0.05) was an important risk factor for mortality in C. auris-infected patients.ConclusionsA 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.

Prevalence, risk factors, treatment and outcome of multidrug resistance Candida auris infections in Coronavirus disease (COVID‐19) patients: A systematic review

“…In the present study, majority of the C. auris ‐infected patients were adults (99%), with one case in the paediatric population, similar to previous reports 4,6,10 . In this study, the pooled prevalence of C. auris infections in COVID‐19 patients was 14%.…”

“…The survival rate for CANC and CAC groups was 77.8% and 35.3%, respectively ( p < .002). Multiple systematic reviews showed that mortality in C. auris cases was at 39% to 47.5% 4,43 . Similar to the present study's findings, Sayeed et al 10 reported a survival rate of 54% in C. auris candidemia cases and 67% in colonised cases.…”

“…1,2 Candida auris is an emerging pathogen in ICU settings with high mortality and infection due to this pathogen has been reported across 44 countries. 3,4 Candida auris is a unique species, as this agent is multidrug-resistant, and they can survive on inanimate objects in the hospital environment for more extended periods, leading to potential transmission among patients (hospital outbreaks), and difficulty in accurate laboratory identification makes them the pathogen of public interest globally. [5][6][7][8] Patients with underlying diseases such as diabetes mellitus, kidney disease, lung disease, trauma, ear diseases and hypertension, followed by iatrogenic risk factors such as prolonged ICU stay, central venous catheter, mechanical ventilation and prior antibiotic usage, were significantly associated with C. auris infections prior to the COVID-19 pandemic.…”

Global prevalence and subgroup analyses of coronavirus disease (COVID‐19) associated Candida auris infections (CACa): A systematic review and meta‐analysis

“…In two studies from a Middle Eastern country, Oman, the overall fatality rate in ICU‐admitted patients was 52.5% 71 and 53.1 72 . Moreover, Hu et al reported a 47.5% mortality rate among 476 cases of C. auris 73 . Compared with the pre‐COVID era, we resulted that the mortality rates in patients with C. auris and COVID‐19 infections increased with a slight slope (overall mortality rate of 67.85% in our analysis) (Table 2 and Supplement 15 in Data ).…”

Emerging Antifungal Targets and Strategies

“…Likewise, multidrug-resistant yeast Candida auris some time ago emerged worldwide and became a significant threat due to its ability to rapidly develop resistance [ 45 ]. One study indicated that 79.6% of C. auris isolates are resistant to fluconazole, while 34.8% and 23.3% are resistant to amphotericin B and voriconazole, respectively [ 46 ].…”