Clinical Microbiology and Infectious Diseases, Faculty of Health Sciences, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa.
Infection Control, National Health Laboratory Service, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa.
Mycoses. 2019 Aug;62(8):620-637. doi: 10.1111/myc.12904. Epub 2019 Jun 18.
A paradigm shift of candidiasis from Candida albicans to non-albicans Candida species has fundamentally increased with the advent of C. auris. C. auris, despite being a newly emerged multidrug-resistant fungal pathogen, is associated with severe invasive infections and outbreaks with high mortality rates. Initially reported from Japan in 2009, C. auris have now been found in different countries on all the continents except Antarctica. Due to its capability of nosocomial transmission and forming adherent biofilms on clinically important substrates, a high number of related hospital outbreaks have been reported worldwide. As C. auris is a multidrug-resistant pathogen and is prone to misidentification by available conventional methods, it becomes difficult to detect and manage C. auris infection and also limits the therapeutic options against this deadly pathogen. The emergence of multidrug-resistant C. auris advocates and amplifies the vigilance of early diagnosis and appropriate treatment of fungal infections. In this review, we discussed the nine-year-old history of C. auris-its trends in global emergence, epidemiological relatedness, isolation, mortality, associated risk factors, virulence factors, drug resistance and susceptibility testing, diagnostic challenges, microbiological characteristics, therapeutic options and infection prevention and control associated with this pathogen.
从白色念珠菌到非白色念珠菌念珠菌属的念珠菌病的范式转变，随着 C. 耳念珠菌的出现而根本增加。C. 耳念珠菌虽然是一种新出现的多药耐药真菌病原体，但与严重的侵袭性感染和高死亡率的暴发有关。C. 耳念珠菌最初于 2009 年在日本报告，现已在除南极洲以外的所有大陆的不同国家发现。由于其能够在医院传播并在临床上重要的基质上形成粘附性生物膜，因此已在全球范围内报告了大量与该菌相关的医院暴发。由于 C. 耳念珠菌是一种多药耐药病原体，并且容易被现有常规方法误识别，因此难以检测和管理 C. 耳念珠菌感染，也限制了针对这种致命病原体的治疗选择。耐多药 C. 耳念珠菌的出现强调了早期诊断和适当治疗真菌感染的重要性。在这篇综述中，我们讨论了 C. 耳念珠菌的九年历史——它在全球的出现趋势、流行病学相关性、分离、死亡率、相关危险因素、毒力因素、耐药性和药敏试验、诊断挑战、微生物学特征、治疗选择以及与该病原体相关的感染预防和控制。
