Candida auris: A systematic review and meta-analysis of current updates on an emerging multidrug-resistant pathogen.
Candida auris: A systematic review and meta-analysis of current updates on an emerging multidrug-resistant pathogen.
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DOI：
10.1002/mbo3.578
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发表时间：
2018-08
期刊：
影响因子：
3.4
通讯作者：
Osei Sekyere J
中科院分区：
文献类型：
--
作者：
Osei Sekyere J
从2009年起，耳念珠菌已成为一种多药耐药子囊菌酵母病原体，具有在患者和医院之间容易传播的能力，以及在环境表面上的持久性。它与高死亡率、突破性和持续性念珠菌血症、药敏试验结果不一致、现有商业鉴定系统的错误鉴定和治疗失败有关，使其管理和检测复杂化。在过去的九年里，C。在远东亚洲、中东、非洲、欧洲、南美洲和北美洲，越来越多地报告了auris，并出现了大量死亡和错误识别。在此，我提供了一个系统和彻底的审查，这种新兴的病原体。Meta分析显示至少742个C. 2013-2017年，16个国家报告了耳道分离株，其中大多数来自印度（≥243）、美国（≥232）和英国（≥103）（p值= 0.0355）。大多数分离株来自男性（64.76%）（p值= .0329）和血液（67.48%）（p值< .0001），粗死亡率较高（29.75%）（p值= .0488）。受影响的患者存在其他合并症：糖尿病（≥52）、脓毒症（≥48）、肺部疾病（≥39）、肾脏疾病（≥32）等（p值< .0001）。对氟康唑（44.29%）、阿替霉素B（15.46%）、伏立康唑（12.67%）、卡泊芬净（3.48%）等的耐药常见（p值= .0059）。常用的诊断工具包括PCR（30.38%）、Bruker MALDI-TOF MS（14.00%）、Vitek 2 YST ID（11.93%）、AFLP（11.55%）和WGS（10.04%）（p值= 0.002）。多药耐药、高归因死亡率和持久性与C.耳感染。两种新药SCY-078和VT-1598目前正在研发中。接触预防措施，严格的感染控制，定期监测和氯基洗涤剂清洁，有效，更快，更便宜的检测工具是预防，遏制和早期诊断C的必要条件。耳感染。
From 2009, Candida auris has emerged as a multidrug‐resistant ascomycete yeast pathogen with the capacity for easy transmission between patients and hospitals, as well as persistence on environmental surfaces. Its association with high mortalities, breakthrough and persistent candidaemia, inconsistencies in susceptibility testing results, misidentification by available commercial identification systems and treatment failure, complicates its management and detection. Within the last nine years, C. auris has been increasingly reported from far‐Eastern Asia, the Middle East, Africa, Europe, South and North America with substantial fatalities and misidentification. Herein, I provide a systematic and thorough review of this emerging pathogen. Meta‐analysis showed that at least 742 C. auris isolates have been reported in 16 countries, with most of these being from India (≥243), USA (≥232) and UK (≥103) (p‐value = .0355) within 2013–2017. Most isolates were from males (64.76%) (p‐value = .0329) and blood (67.48%) (p‐value < .0001), with substantial crude mortality (29.75%) (p‐value = .0488). Affected patients presented with other comorbidities: diabetes (≥52), sepsis (≥48), lung diseases (≥39), kidney diseases (≥32) etc. (p‐value < .0001). Resistance to fluconazole (44.29%), amphotericin B (15.46%), voriconazole (12.67%), caspofungin (3.48%) etc. were common (p‐value = .0059). Commonly used diagnostic tools included PCR (30.38%), Bruker MALDI‐TOF MS (14.00%), Vitek 2 YST ID (11.93%), AFLP (11.55%) and WGS (10.04%) (p‐value = .002). Multidrug resistance, high attributable mortality and persistence are associated with C. auris infections. Two novel drugs, SCY‐078 and VT‐1598, are currently in the pipeline. Contact precautions, strict infection control, periodic surveillance and cleaning with chlorine‐based detergents, efficient, faster and cheaper detection tools are necessary for prevention, containment and early diagnosis of C. auris infections.
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作者：
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通讯作者：
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作者：
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DOI：
10.1007/s10096-013-2027-1
发表时间：
2014-06-01
影响因子：
4.5
作者：
Chowdhary, A.;Kumar, V. Anil;Meis, J. F.
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