Forsberg Kaitlin, Woodworth Kate, Walters Maroya, Berkow Elizabeth L, Jackson Brendan, Chiller Tom, Vallabhaneni Snigdha
Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
IHRC, Inc., Atlanta, Georgia, USA.
Med Mycol. 2019 Jan 1;57(1):1-12. doi: 10.1093/mmy/myy054.
Candida auris is an emerging multidrug-resistant yeast that causes serious invasive infections with high mortality. It was first discovered in 2009, and since then, individual cases or outbreaks have been reported from over 20 countries on five continents. Controlling C. auris is challenging for several reasons: (1) it is resistant to multiple classes of antifungals, (2) it can be misidentified as other yeasts by commonly available identification methods, and (3) because of its ability to colonize patients perhaps indefinitely and persist in the healthcare environment, it can spread between patients in healthcare settings. The transmissibility and high levels of antifungal resistance that are characteristic of C. auris set it apart from most other Candida species. A robust response that involves the laboratory, clinicians, and public health agencies is needed to identify and treat infections and prevent transmission. We review the global emergence, biology, challenges with laboratory identification, drug resistance, clinical manifestations, treatment, risk factors for infection, transmission, and control of C. auris.
耳念珠菌是一种新出现的多重耐药酵母,可引起严重的侵袭性感染,死亡率很高。它于2009年首次被发现,自那时以来,五大洲20多个国家都报告了个别病例或疫情。控制耳念珠菌具有挑战性,原因如下:(1)它对多种抗真菌药物耐药;(2)常用的鉴定方法可能会将其误鉴定为其他酵母;(3)由于它能够在患者体内长期定植并在医疗环境中持续存在,因此可在医疗机构内的患者之间传播。耳念珠菌的传播性和高度抗真菌耐药性使其有别于大多数其他念珠菌物种。需要实验室、临床医生和公共卫生机构共同做出有力反应,以识别和治疗感染并预防传播。我们综述了耳念珠菌在全球的出现情况、生物学特性、实验室鉴定面临的挑战、耐药性、临床表现、治疗、感染的危险因素、传播及防控。