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首页> 外文期刊>Journal of Medical Microbiology: An Official Journal of the Pathological Society of Great Britain and Ireland >On the emergence, spread and resistance of Candida auris: host, pathogen and environmental tipping points
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On the emergence, spread and resistance of Candida auris: host, pathogen and environmental tipping points

机译：关于<斜视>念珠菌的出现，传播和抗性：宿主，病原体和环境划分点

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Over a decade ago, a multidrug-resistant nosocomial fungus Candida auris emerged worldwide and has since become a significant challenge for clinicians and microbiologists across the globe. A resilient pathogen, C. auris survives harsh disinfectants, desiccation and high-saline environments. It readily colonizes the inanimate environment, susceptible patients and causes invasive infections that exact a high toll. Prone to misidentification by conventional microbiology techniques, C. auris rapidly acquires multiple genetic determinants that confer multidrug resistance. Whole-genome sequencing has identified four distinct clades of C. auris , and possibly a fifth one, in circulation. Even as our understanding of this formidable pathogen grows, the nearly simultaneous emergence of its distinct clades in different parts of the world, followed by their rapid global spread, remains largely unexplained. We contend that certain host–pathogen–environmental factors have been evolving along adverse trajectories for the last few decades, especially in regions where C. auris originally appeared, until these factors possibly reached a tipping point to compel the evolution, emergence and spread of C. auris . Comparative genomics has helped identify several resistance mechanisms in C. auris that are analogous to those seen in other Candida species, but they fail to fully explain how high-level resistance rapidly develops in this yeast. A better understanding of these unresolved aspects is essential not only for the effective management of C. auris patients, hospital outbreaks and its global spread but also for forecasting and tackling novel resistant pathogens that might emerge in the future. In this review, we discuss the emergence, spread and resistance of C. auris , and propose future investigations to tackle this resilient pathogen.
机译：十年前，在全球范围内出现了一种多药耐药神经内杀菌念珠菌念珠菌，自全球对临床医生和微生物学家成为一项重大挑战。弹性病原体，C.Auris存活恶劣消毒剂，干燥和高盐水环境。它易于殖民化无生命的环境，易感患者，并导致精确损伤的侵袭性感染。易于通过常规微生物技术误诊，C.Auris迅速获取多种赋予多药耐药性的多种遗传决定因素。全基因组测序已经确定了四种不同的C. auris曲面，并且可能是第五个循环。即使我们对这种强制性病原体的理解增长，其在世界不同地区的近似同时出现的曲线，其次是其快速的全球传播，仍然很大程度上是未解释的。我们争辩说，某些宿主病原 - 环境因素在过去的几十年中一直在不利轨迹的发展，特别是在C. Auris最初出现的地区，直到这些因素可能达到尖顶，以强制进化，出现和传播C 。Auris。对比基因组学有助于识别与其他念珠菌种类类似的C. auris的几种抗性机制，但它们未能充分解释该酵母在此酵母中迅速发展的高层抵抗力。更好地理解这些未解决的方面对于C.Auris患者，医院爆发及其全球传播的有效管理至关重要，而且是对未来可能出现的新的抗性病原体的预测和解决这些抗性病原体。在这篇综述中，我们讨论了C. auris的出现，传播和抗性，并提出了未来的调查来解决这种弹性病原体。

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