ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2017
Simultaneous Emergence of Multidrug-Resistant Candida auris on 3 Continents Confirmed by Whole-Genome Sequencing and Epidemiological Analyses.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1,015 papers, 2 of them syntheses that pooled it.
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Who cites it
1,015 citing papers in PubMed, 2 syntheses or guidelines pooled it, 1,583 citations in OpenAlex.
- Global prevalence, mortality, and comorbidities of patients with diabetes mellitus and proven Candida auris emerging infection: a systematic review & meta-analysis.BMC infectious diseases · 2026Pooled it
- Antifungal resistance and poor clinical outcome rates ofFrontiers in microbiology · 2026Pooled it
- Pharmacological advances inJournal of enzyme inhibition and medicinal chemistry · 2026Review
- Population genomics reveals a long-term increase in azole resistance associated with the emerging cluster AZR amongEmerging microbes & infections · 2026Article
- Micafungin microevolution inVirulence · 2026Article
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- Pathogenicity and virulence ofVirulence · 2026Review
- Clade Differentiation ofAnnals of laboratory medicine · 2026Article
- FKS1/2-variant independent mechanisms underlying the emergence of resistance in echinocandin-refractory Candida auris infections.Nature communications · 2026Article
- A Synthetic β-Mannan Epitope Enables Immunization and Detection of Candida auris.Angewandte Chemie (International ed. in English) · 2026Article
- 30-day mortality and antifungal resistance in confirmed Candida auris bloodstream infections (BSI): a systematic review and meta-analysis.Infection · 2026Review
- mSphere of Influence: The age of antifungal resistance.mSphere · 2026Article
- Baicalein suppresses adhesion and biofilm formation inMicrobiology spectrum · 2026Article
- Climate change and antimicrobial resistance.Nature reviews. Microbiology · 2026Review
- First Case of Bloodstream Infection byAnnals of laboratory medicine · 2026Article
- Proteome Remodelling inJournal of fungi (Basel, Switzerland) · 2026Article
- Outbreaks of fluconazole-resistant Candida parapsilosis are driven by low-biofilm-producing isolates that emerge under host selection.PLoS biology · 2026Article
- Candida auris uses nutrient sensing to modulate virulence and host immune responses.Nature microbiology · 2026Article
- Candidemia in Colombia: Species Distribution and Antifungal Susceptibility Profiles of Yeast Bloodstream Isolates from a Six-Year Multicentre Surveillance Study.Journal of fungi (Basel, Switzerland) · 2026Article
- Antimicrobial Peptides as Eco-Innovative Therapeutics to Overcome Antifungal Pressure-Induced Resistance in Candida Infections.Current microbiology · 2026Review
955 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Erratum issuedErratum.2018
Authors and funding
19 authors at 8 institutions in 6 countries.
Funding
Abstract
backgroundCandida auris, a multidrug-resistant yeast that causes invasive infections, was first described in 2009 in Japan and has since been reported from several countries.
methodsTo understand the global emergence and epidemiology of C. auris, we obtained isolates from 54 patients with C. auris infection from Pakistan, India, South Africa, and Venezuela during 2012-2015 and the type specimen from Japan. Patient information was available for 41 of the isolates. We conducted antifungal susceptibility testing and whole-genome sequencing (WGS).
resultsAvailable clinical information revealed that 41% of patients had diabetes mellitus, 51% had undergone recent surgery, 73% had a central venous catheter, and 41% were receiving systemic antifungal therapy when C. auris was isolated. The median time from admission to infection was 19 days (interquartile range, 9-36 days), 61% of patients had bloodstream infection, and 59% died. Using stringent break points, 93% of isolates were resistant to fluconazole, 35% to amphotericin B, and 7% to echinocandins; 41% were resistant to 2 antifungal classes and 4% were resistant to 3 classes. WGS demonstrated that isolates were grouped into unique clades by geographic region. Clades were separated by thousands of single-nucleotide polymorphisms, but within each clade isolates were clonal. Different mutations in ERG11 were associated with azole resistance in each geographic clade.
conclusionsC. auris is an emerging healthcare-associated pathogen associated with high mortality. Treatment options are limited, due to antifungal resistance. WGS analysis suggests nearly simultaneous, and recent, independent emergence of different clonal populations on 3 continents. Risk factors and transmission mechanisms need to be elucidated to guide control measures.
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