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Epidemiology, Clinical Features and Antifungal Resistance Profile of Candida auris in Africa: Systematic Review

Journal of Biosciences and Medicines 2024年第1期12卷 126-149页

作者： Isidore Wendkièta Yerbanga Seydou Nakanabo Diallo Toussaint Rouamba Delwendé Florence Ouedraogo Katrien Lagrou Rita Oladele Jean-Pierre Gangneux Olivier Denis hector rodriguez-villalobos Isabel Montesinos Sanata Bamba Centre Hospitalier Universitaire Régional de Ouahigouya Ouahigouya Burkina Faso Ecole Doctorale des Sciences De la Santé Université Nazi Boni Bobo-Dioulasso Burkina Faso Centre Muraz/Institut National de Santé Publique Bobo-Dioulasso Burkina Faso Clinical Research Unit of Nanoro Institute for Research in Health Sciences National Center for Scientific and Technological Research Ouagadougou Burkina Faso Department of Microbiology Immunology and Transplantation KU Leuven Leuven Belgium and Department of Laboratory Medicine and National Reference Center for Mycosis Excellence Center for Medical Mycology (ECMM) University Hospitals Leuven Leuven Belgium College of Medicine University of Lagos Lagos Nigeria Univ Rennes CHU Rennes Inserm Irset (Institut de recherche en santé environnement et travail) European ECMM Excellence Center in Medical Mycology Université de Rennes Rennes France Department of Microbiology CHU Namur site-Godinne Université Catholique de Louvain Yvoir Belgium Ecole de Santé Publique Université Libre de Bruxelles Brussels Belgium Department of Microbiology Cliniques Universitaires Saint-Luc—Université Catholique de Louvain Bruxelles Belgium Centre Hospitalier Universitaire Sour? Sanou Bobo-Dioulasso Burkina Faso

Candida auris since it discovery in 2009 is becoming a severe threat to human health due to its very quickly spread, its worldwide high resistance to systemic antifungal drugs. In resource-constrained settings where several conditions are met for its emergence and spread, this worrisome fungus could cause large hospital and/or community-based outbreaks. This review aimed to summarize the available data on C. auris in Africa focusing on its epidemiology and antifungal resistance profile. Major databases were searched for articles on the epidemiology and antifungal resistance profile of C. auris in Africa. Out of 2,521 articles identified 22 met the inclusion criteria. In Africa, nearly 89% of African countries have no published data on C. auris. The prevalence of C. auris in Africa was 8.74%. The case fatality rate of C. auris infection in Africa was 39.46%. The main C. auris risk factors reported in Africa were cardiovascular disease, renal failure, diabetes, HIV, recent intake of antimicrobial drugs, ICU admissions, surgery, hemodialysis, parenteral nutrition and indwelling devices. Four phylogenetic clades were reported in Africa, namely clades I, II, III and IV. Candida auris showed a pan-African very high resistance rate to fluconazole, moderate resistance to amphotericin B, and high susceptibility to echinocandins. Finally, C. auris clade-specific mutations were observed within the ERG2, ERG3, ERG9, ERG11, FKS1, TAC1b and MRR1 genes in Africa. This systematic review showed the presence of C. auris in the African continent and a worrying unavailability of data on this resilient fungus in most African countries.

关键词： Africa Antifungal Resistance Candida auris Clinical Features Phylogenetic Clades

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