PDF(Pubmed)
Abstract：
The emergent fungal pathogen Candida auris is increasingly recognised as an important cause of healthcare-associated infections globally. It is highly transmissible, adaptable, and persistent, resulting in an organism with significant outbreak potential that risks devastating consequences. Progress in the ability to identify C. auris in clinical specimens is encouraging, but laboratory diagnostic capacity and surveillance systems are lacking in many countries. Intrinsic resistance to commonly used antifungals, combined with the ability to rapidly acquire resistance to therapy, substantially restricts treatment options and novel agents are desperately needed. Despite this, outbreaks can be interrupted, and mortality avoided or minimised, through the application of rigorous infection prevention and control measures with an increasing evidence base. This review provides an update on epidemiology, the impact of the COVID-19 pandemic, risk factors, identification and typing, resistance profiles, treatment, detection of colonisation, and infection prevention and control measures for C. auris. This review has informed a planned 2024 update to the United Kingdom Health Security Agency (UKHSA) guidance on the laboratory investigation, management, and infection prevention and control of Candida auris. A multidisciplinary response is needed to control C. auris transmission in a healthcare setting and should emphasise outbreak preparedness and response, rapid contact tracing and isolation or cohorting of patients and staff, strict hand hygiene and other infection prevention and control measures, dedicated or single-use equipment, appropriate disinfection, and effective communication concerning patient transfers and discharge.
摘要：
新兴的真菌病原体耳念珠菌越来越被认为是全球医疗保健相关感染的重要原因。它是高度可传播的，适应性强,和持久的，导致具有重大爆发潜力的生物，有破坏性后果的风险。在临床标本中鉴定金黄色葡萄球菌的能力方面取得了令人鼓舞的进展，但是许多国家缺乏实验室诊断能力和监测系统。对常用抗真菌药的内在抗性，结合快速获得对治疗的抵抗力的能力，大大限制了治疗选择，迫切需要新的药物。尽管如此,爆发可以中断，避免或最小化死亡率，通过应用严格的感染预防和控制措施和越来越多的证据基础。这篇综述提供了流行病学的最新信息，COVID-19大流行的影响，危险因素，识别和打字，电阻剖面，治疗,检测定殖，以及金黄色葡萄球菌感染的预防和控制措施。该审查已告知英国卫生安全局（UKHSA）关于实验室调查的计划2024更新。管理,以及耳念珠菌感染的预防和控制。需要采取多学科应对措施来控制医疗保健环境中的C.auris传播，并应强调疫情的准备和应对。患者和工作人员的快速接触追踪和隔离或队列，严格的手卫生和其他感染预防和控制措施，专用或一次性设备，适当的消毒，以及有关患者转移和出院的有效沟通。
