Table 2.
Geographical distribution, demographics, specimen sources, resistance profiles, diagnostics and clinical data of Candida auris isolates identified between 2006/9 and 2017
| Country (n) | Year (n) | Age(n)/sex | Specimen source (n) | MICa (μg/ml) | Resistance mechanisms | Diagnostics used | Co‐morbidity | Clinical outcome (n) | References |
|---|---|---|---|---|---|---|---|---|---|
| Canada (5) | 2017 (5) | 64 (1)/Mb | Ear discharge (1) | FLZc = 128, AMBd = 2, MCFe = 0.5 | NDf | MALDI‐TOF MS, WGSg | Chronic otitis media, odontogenic brain abscess | Alive | Schwartz and Hammond (2017) |
| Colombia (17) | 2016 (17) | 0–77 (9)/M, NSh (6)/Fi | Blood (13), peritoneal fluid (1), CSFj (1), bone (1), urine (1) | FLZ = 16–>64, VRZk < 0.12–2, AMB = 8‐>16, MCF < 0.06–0.25, CFGl < 0.25–0.5 | ND | API 20C, VITEK 2 YST ID, Phoenix BD, Microscan(Walkaway and AutoSCAN 4), CHROMagar, MALDI‐TOF MS | Diabetes (3), pancreatitis (2), cancer (2), HIV (1) | Demised (6) | Morales‐Lopez et al. (2017) |
| Germany (2) | NS | 68 (1)/M | Blood (2) | SCY‐078m = 0.5, FLZ > 64, ISAn = 0.031, ITZo = 0.5, PSZp = 0.25–0.5, VRZ = 0.125–0.5, AMB = 4, FCNq = 0.5, ANFr = 0.25, CFG = 0.5, MCF = 0.25 | ND | API 20C AUX, VITEK 2 YST ID, PCR and sequencing (of ITS1/4s | NS | NS | Larkin et al. (2017) |
| Germany (1) | 2015 (1) | NS | Blood (1) | NS | ND | NS | NS | NS | European Centre for Disease Prevention and Control (2016) |
| India (90) | 2010–14 (90) | NS | Blood (78), gangrenous tissue (NS), pleural fluid (NS), peritoneal fluid (NS), urine (NS), sputum (NS) | AMB = 0.125–8, ITZ < 0.03–2, VRZ < 0.03–16 ISA < 0.015–4, PSZ < 0.015–8, FLZ = 4–>64 FCN < 0.125–>64, CFG = 0.125–8, MCF < 0.015–8 ANF < 0.015–8 | ND, no mutations in FKS1/2 genes | MALDI‐TOF MS, AFLP, PCR and sequencing (of ITS1, LSU and RPB1) | NS | NS | Kathuria et al. (2015), Prakash et al. (2016) |
| India (74) | 2011–12 (74) | 49.7 (Mean age); M = 46, F = 28, adults=52 | Blood (74) | R (FLZ = 43), R (VRZ = 2), R (ITZ = 3), R (CFG = 7), R (AMB = 10) | ND | VITEK 2 YST ID, PCR and sequencing (of ITS1 and D1/D2) | Pulmonary (30), renal (16), cardiovascular (15), gastrointestinal (7), and liver (5) diseases | 41.9%–44.7% crude mortalities (19.6%–27% attributable mortalities) | Chakrabarti et al. (2015), Rudramurthy et al. (2017) |
| India (19), Pakistan (19), South Africa (10), Venezuela (5), | 2012–15 (53) | 24–69 (53)/M = 26, F = 15, NS=13 | Blood (n = 27), urine (n = 10), tissue (n = 5) or other (n = 11) | FLZ = 4–256, VRZ = 0.03–16, ITZ = 0.125–2, PSZ = 0.06–1, CFG = 0.03–16, ANF = 0.125–16, MCF = 0.06–4, FCN = 0.125–128, AMB = 0.38–4 | ERG11 mutations: F126T, Y132F, Y132F, K143R | WGS | Diabetes (34), solid tumor (12), liver disease (8), immunocompromised (20) | Demised (24) | Lockhart et al. (2017) |
| India (17) | 2013–14 (17) | NS | NS | NS | ND | VITEK 2 YST ID, VITEK 2 MS, PCR and sequencing (of 18S rRNA) | NS | NS | Wattal et al. (2017) |
| India (15) | 2011–13 (15) | 48, 80 &87 (3)/F2 (1)/M, 20–79 (8)/M | Blood (7), pus (1), CVCt (3), surgical tissue (3), Broncho alveolar lavage (BAL) (1) | FLZ = 64, VRZ = 0.5–4, FCN = 0.25–64, CFG = 0.25–1, PSZ = 0.015–0.125, ITZ = 0.06–0.25, ISA = 0.06–0.5, AMB = 0.25–1, MCF = 0.06–0.125, ANF = 0.125–0.25 | ND | CHROMagar, PCR and sequencing (of ITS and D1/D2) | Diabetes (5), chronic kidney disease (4), malignancies (3), sepsis (4), acute renal failure (2), chronic kidney disease (3), (broncho‐)pneumonia (2), peripheral occlusive vascular disease (3), IgA nephropathy, hydronephrosis etc. | Demised (4) | Chowdhary et al. (2014) |
| India (12) | 2009–11 (12) | NS | Blood (12) | FLZ = 16–64, AMB = 0.25–1, ITZ = 0.125–0.25, VRZ = 0.125–1 ISA < 0.015–0.25, PSZ = 0.06–0.25, FCN = 0.125, CFG = 0.125–0.25, MCF = 0.06–0.125, ANF = 0.125–0.5 | ND | API 20C, VITEK 2 YST ID, PCR and sequencing (of ITS1 and D1/D2), AFLPu | Immunosuppressive conditions (7), diabetes (6), CKDv, cancer chemotherapy (2), HIV (1), low birth weight (3), sepsis (1), acute lymphoblastic leukemia (1) | Demised (6) | Chowdhary et al. (2013) |
| India (5) | 2012–14 (5) | NS | Blood (5) | FLZ = 16–64, AMB = 4–16, FCN = 1, CFG = 0.25 | ND | VITEK 2 YST ID, WGS, PCR (MFα) | Sepsis and multiorgan dysfunction (1) | NS | Chatterjee et al. (2015) |
| India (4) | 2013 (4) | 43/M | Pericardial fluid (1), blood (1), BAL (1) and urine (1) | AMB = 0.125–0.5, CFG = 1, FLZ > 64, PSZ ≤ 0.015, ITZ = 0.03–0.125, VRZ = 0.06–0.125, FCN = 0.125–4, MCF = 0.06, ANF = 0.125–0.25 | ND | CHROMagar, Vitek 2, PCR and sequencing (of ITS and D1/D2) | Chronic liver disease | Demised (1) | Khillan et al. (2014) |
| India (3) | 2013–14 (3) | NS | Blood (3) | NS | ND | MALDI‐TOF MS, PCR and sequencing (of ITS1 and D1/D2) | NS | NS | Ghosh et al. (2015) |
| India (2) | 2011 (2) | NS | NS | FLZ = 64, VRZ = 2, AMB = 16, FCN = 1 | ND | Vitek 2, PCR and sequencing (of ITS and D1/D2) | NS | Demised (≤2) | Sarma et al. (2013) |
| India (1) | NS | 28 (1)/F | Vaginal swab (1) | ITZ ≥ 2FLZ ≤ 16, VRZ ≤ 0.5 and AMB ≤ 0.5 | ND | CHROMagar, PCR and sequencing (of ITS1) | Vulvovaginitis | Survived (1) | Kumar et al. (2015) |
| India (1) | 2015 | NS | Blood (1) | FLZ = 64 | ND | Vitek 2, PCR and sequencing (of ITS and D1/D2, RPB1/2) | NS | NS | Sharma et al. (2015) |
| Israel, Tel Aviv (6) | 2014 (4), 2015 (1), 2014–15 (1) | NS | Blood (5), NS (1) | FLZ = 32–64, ITZ = 0.5, VRZ = 0.5–1, PSZ = 0.12–0.5, AMB = 1–2, ANF = 0.03, MCF = 0.12–0.25, CSF = 0.5, FCN = 0.25–1 | ND, higher ABC efflux activity | CHROMagar Candida, VITEK 2 YST ID, PCR and sequencing | HIV (1), blood stream infections (5) | Demised (2) | Ben‐Ami et al. (2017) |
| Japan (1) | 2009 (1) | 70 (1)/F | Ear discharge (1) | FLZ = 2, VRZ = 0.031, ITZ = 0.063, FCN = 0.5 | ND | CHROMagar, Vitek 2, PCR and sequencing (of ITS and D1/D2) | NS | Alive | Satoh et al. (2009) |
| Kuwait (1) | 2014 (1) | 27/F | Blood (1) | FLZ ≥ 256, AMB = 0.064, VRZ = 0.38, CFG = 0.0064 | ND | VITEK 2, MAST ID CHROMagar, PCR (of ITS1 and D1/D2) | Chronic renal failure, lobar pneumonia, immotile cilia syndrome, bronchiectasis, recurrent sinusitis | Demised | Emara et al. (2015) |
| Norway (1) | NS (1) | NS | Blood (1) | NS | ND | NS | NS | NS | European Centre for Disease Prevention and Control (2016) |
| Oman (5) | 2016–17 (5) | 62 (2)/M, 71 (1)/M, 31 (1)/F, 62 (1)/F | Blood (5) | FLZ = 128‐>256, VRZ = 0.5–2, ITZ = 0.12–0.25, PSZ = 0.06–0.12, ANF = 0.12, CFG = 0.08–0.12, MCF = 0.06–0.12, AMB = 1–2, FCN = 0.06–8 | ND | BD Phoenix Yeast ID panel | Diabetes mellitus (2), cerebrovascular accident (1), chronic kidney disease (1), sepsis (1), acute limb ischemia (1), metastatic endometrial cancer (1), obstructive uropathy (1), infected below knee amputation stump (1), kidney transplant (1), systemic lupus erythematosus (1), pneumonitis (1) | Demised (3) | Al‐Siyabi et al. (2017) |
| Oman (2) | 2016 (1), 2017 (1) | 70 (1)/F, 77 (1)/M | Blood (2) | FLZ ≥ 64, ITZ = 0.125–0.031, VRZ = 0.125–1, PSZ < 0.016–0.125, ISA < 0.016–0.125, AMB = 1–2, ANF = 0.031–0.125, MCF = 0.063–0.125 | ND | API20C‐ AUX, MALDI‐TOF MS, PCR and sequencing (of ITS and LSU rRNA), AFLP | Diabetes, hypertension, cardiac failure, edema and cellutitis (1), diabetes, osteomyelitis and septic shock (1) | Demised (1) | Mohsin et al. (2017) |
| South Africa (4) | 2012–13 (4) | 85 (1), 73 (1), 60 (1), 27 (1) | Blood (4) | FLZ = 64‐>256, VRZ = 0.25–2, PSZ = 0.015–0.06, ITZ = 0.06–0.25, FCN = 0.06–0.12, CFG = 0.03–0.25, MCF = 0.06–0.12, ANF = 0.06–0.25 | ND | API 20C, VITEK 2 YST ID, PCR and sequencing (of ITS1 and D1/D2) | NS | NS | Magobo et al. (2014) |
| South Korea (20) | 2006 (15), 2007–10 (5) | NS | Ear (17), blood (3) | FLZ = 2–128, AMB = 0.38–1.5, ITZ = 0.125–4, VRZ = 0.03–2, CFG = 0.125–0.25, MCF = 0.03 | ND | VITEK 2 YST ID, PCR and sequencing (of ITS1 and D1/D2) | Otitis media (17), candidaemia (3) | Survived (17), NS (3) | Kim et al. (2009), Oh et al. (2011), Shin et al. (2012) |
| South Korea (3) | 1996 (1), 2009 (2) | 1 (1)/F, 1 (1)/M, 74 (1)/M | Blood (3) | AMB = 0.5–1, FLZ = 2–128, ITZ = 0.125–2, VRZ = 0.06–1, CFG = 0.06, MCF = 0.03 | ND | API 20C, VITEK 2 YST ID, PCR and sequencing (of ITS1 and D1/D2) | Hypoxic encephalopathy and aspiration pneumonia (1), laryngeal carcinoma (1), hemophagocytic lymphohistiocytosis (1) | Demised (2) | Lee et al. (2011) |
| South Korea (2) | 2010–13 (2) | NS | Ear discharge (2) | NS | ND | Phoenix BD system, VITEK 2 YST ID, MALDI TOF MS (VITEK MS and Bruker) PCR and sequencing (of ITS1 and D1/D2) | NS | NS | Kim et al. (2016) |
| Spain (34) | 2016 (34) | NS | Blood (34) | NS | ND | NS | Blood stream infection (34) | NS | European Centre for Disease Prevention and Control (2016) |
| Spain (8) | 2016 (8) | 66 (1)/M, 48 (1)/M, 26 (1)/M, 39 (1)/F, | Blood, CVC tip, urine, peritoneal fluid, pharyngeal, and rectal culture (4) | FLZ > 256, VRZ = 2, susceptible to PSZ, ITZ, MCF, ANF and AMB | ND | CHROMagar Candida ®, BBL Mycosel agar, API ID20C, AuxaColor, VITEK MS, PCR & sequencing of ITS | Hepatocellular carcinoma (1), ventricular dysfunction and multiple organ dysfunction syndrome (1), poly(thoracic)trauma (2), | Alive (2Demised (2) | Ruiz Gaitán et al. (2017) |
| UK (53) | 2013 (3), 2014 (1), 2015 (7), 2016 (4), 2014–16 (7) | NS | Blood (7), sputum (2), groin swab (2), CSF (1), NS (18), line (1), arterial line (1), pleural fluid (2), urine (1), pustule swab (1), wound swab (3), femoral line (2), swab (2) | FLZ = 8−>64, VRZ = 0.06–2, PSZ = <0.03–1, ANF = 0.03–0.5, FCN = <0.125–0.25, AMB = 05–1 | ND | PCR (of 28s rRNA/ITS1), MALDI‐TOF MS | NS | NS | Borman et al. (2016, 2017) |
| UK (50) | 2015–16 (50) | 19–78 (50)/M = 33, F = 17 | Wound swabs, urine samples, vascular devices tips, blood cultures, skin (nose, axilla, groin) stool samples | FLZ > 256, AMB = 0.5–2M, FCN <0.06–0.12, ANF/MCF/CFG = 0.06–0.25 | ND | Brilliance Candida Agar, MALDI‐TOF, AFLP | Cardiac surgery | Survived (50) | Schelenz et al. (2016) |
| United states (224: 104 are clinical, 120 are colonized patients) | 2016–17 (224) | 21–96 (69)/55%M | Blood (40), urine (10), respiratory tract (8), bile fluid (4), wound (1), CVC tip (2), bone (1), jejunal biopsy (1) | Rw (FLZ>32) = 30, R(AMB≥2) = 15, R(MCF/ANF/CFG >4) = 1 | ND | WGS | NS | NS | Centers for Disease Control and Prevention (2017a), Tsay et al. (2017) |
| United States (7) | 2013 (1), 2015 (1), 2016 (5) | Not specified (NS) | Blood (5), urine (1), external ear canal (1) | R (FLZ) = 5 isolates, R(AMB) = 1, R (MCF/ANF/CFG) = 1 | ND | WGS | Hematologic malignancies (n = 2), bone marrowtransplantation (n = 1),acute respiratory failure (n = 1), peripheral vascular disease and skull base osteomyelitis (n = 1), brain tumor, villous adenoma resection (1). | Demised (4), alive (3) | Vallabhaneni et al. (2016) |
| United States, Massachusetts (1) | 2017 (1) | 71(1)/M | BAL | FLZ = 4, VRZ = 0.03, CFG = 0.12, MCF = 0.12, FCN = 0.12, AMB = 2 | ND | CHROMagar Candida, VITEK MS, VITEK 2 YST ID, MALDI‐TOF MS | Idiopathic pulmonary fibrosis, chronic obstructive lung disease | Demised | Azar et al. (2017) |
| Venezuela (18) | 2012–13 (18) | <1 year (6)/M<1 year (6)/F14 (1)/F72 (1)/F21–29 (2)/M40–48 (2)/M | Blood (18) | FLZ > 64, VRZ = 4, AMB = 2, FCN = 0.5, ANF = 0.125 | ND | VITEK 2 YST ID, PCR and sequencing (of ITS), AFLP | Preterm neonates (8), cancer (1), | Demised (5) | Calvo et al. (2016) |
a
Minimum inhibitory concentration. Tentative MIC breakpoints proposed by the CDC (Centers for Disease Control and Prevention, 2017b) were used for interpretation: Resistance to FLZ ≥ 32L, AMB ≥ 2, ANF ≥ 4, CFG ≥ 2 and MCF ≥ 4.
b
Male.
c
Fluconazole.
d
Amphotericin B.
e
Micafungin.
f
Not determined.
g
Whole genome sequencing.
h
Not stated.
i
Female.
j
Cerebrospinal fluid.
k
Voriconazole.
l
Caspofungin.
m
A novel orally bioavailable 1,3‐β‐D‐glucan synthesis inhibitor antifungal drug.
n
isavuconazole.
o
Itraconazole.
p
Posaconazole.
q
Flucytosine.
r
Anidulafungin.
s
Internal transcribed spacer region.
t
Central venous catheter.
u
Amplified fragment length polymorphism.
v
Chronic kidney disease.
w
Resistance: R (FLZ) = fluconazole resistance, R (AMB) = amphotericin B resistance.