Discussion on the construction of fungal disease prevention and control system in China from the epidemic of <i>Candida auris</i>_West China Medical Journal

Authors：

SUN Huaiyuan ¹ , FENG Jiajia ¹ , KONG Weihua ¹ ,  LIN Likai ¹ ,  XU Yingchun ² ,  CHEN Nan ³

1. Management Institute, Wuhan University Hospital, Wuhan, Hubei 430071, P. R. China;
2. Department of Clinical Laboratory, Peking Union Medical College Hospital, Beijing 100000, P. R. China;
3. Pharmacy Department, People’s Hospital of Zhengzhou, Zhengzhou, Henan 450000, P. R. China;

Corresponding author：

LIN Likai, Email: 1875278110@qq.com; XU Yingchun, Email: xycpimch@139.com; CHEN Nan, Email: 13598878231@163.com

Keywords：

Candida auris; fungal disease; prevention and control system construction

DOI：

10.7507/1002-0179.202502157

Video：

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Candida auris is an emerging multidrug-resistant fungus that has become a significant global public health threat due to its strong resistance to antifungal agents and its ability to spread within healthcare facilities. This paper reviews the global epidemiological trends of Candida auris and the current status of existing prevention and control systems, focusing specifically on pathogen epidemiological characteristics, domestic and international epidemic situations, current prevention and control frameworks, and the construction of prevention networks. In response to the challenges posed by the international spread of Candida auris , China’s fungal disease prevention system should advance towards a more systematic and scientific direction. By integrating resources from medical institutions, disease control agencies, and research institutes, and combining multidisciplinary knowledge and technologies, China should establish a multi-level coordinated prevention and control mechanism to improve its monitoring, prevention, and treatment systems. In the future, China’s fungal disease prevention and control system needs to further strengthen talent cultivation, improve surveillance networks, promote technological innovation, and build a comprehensive, multi-level modern prevention and control system.

Citation： SUN Huaiyuan, FENG Jiajia, KONG Weihua, LIN Likai, XU Yingchun, CHEN Nan. Discussion on the construction of fungal disease prevention and control system in China from the epidemic of Candida auris. West China Medical Journal, 2025, 40(3): 337-342. doi: 10.7507/1002-0179.202502157 Copy

1.	徐英春, 黄晶晶, 肖盟, 等. 中国耳念珠菌临床感染现状. 协和医学杂志, 2019, 10(5): 442-445.
2.	Satoh K, Makimura K, Hasumi Y, et al. Candida auris sp. nov., a novel ascomycetous yeast isolated from the external ear canal of an inpatient in a Japanese hospital. Microbiol Immunol, 2009, 53(1): 41-44.
3.	Chowdhary A, Sharma C, Duggal S, et al. New clonal strain of Candida auris, Delhi, India. Emerg Infect Dis, 2013, 19(10): 1670-1673.
4.	Lee WG, Shin JH, Uh Y, et al. First three reported cases of nosocomial fungemia caused by Candida auris. J Clin Microbiol, 2011, 49(9): 3139-3142.
5.	Magobo RE, Corcoran C, Seetharam S, et al. Candida auris-associated candidemia, South Africa. Emerg Infect Dis, 2014, 20(7): 1250-1251.
6.	World Health Organization. WHO fungal priority pathogens list to guide research, development and public health action. Geneva: World Health Organization, 2022.
7.	Alanio A, Snell HM, Cordier C, et al. First patient-to-patient intrahospital transmission of clade I Candida auris in France revealed after a two-month incubation period. Microbiol Spectr, 2022, 10(5): e0183322.
8.	Huang X, Hurabielle C, Drummond RA, et al. Murine model of colonization with fungal pathogen Candida auris to explore skin tropism, host risk factors and therapeutic strategies. Cell Host Microbe, 2021, 29(2): 210-221.e6.
9.	Sikora A, Hashmi MF, Zahra F. Candida auris. Treasure Island: StatPearls, 2025.
10.	Kim TH, Kweon OJ, Kim HR, et al. Identification of uncommon Candida species using commercial identification systems. J Microbiol Biotechnol, 2016, 26(12): 2206-2213.
11.	Kathuria S, Singh PK, Sharma C, et al. Multidrug-resistant Candida auris misidentified as Candida haemulonii: characterization by matrix-assisted laser desorption ionization-time of flight mass spectrometry and DNA sequencing and its antifungal susceptibility profile variability by Vitek 2, CLSI broth microdilution, and Etest method. J Clin Microbiol, 2015, 53(6): 1823-1830.
12.	Spivak ES, Hanson KE. Candida auris: an emerging fungal pathogen. J Clin Microbiol, 2018, 56(2): e01588-17.
13.	Ostrowsky B, Greenko J, Adams E, et al. Candida auris isolates resistant to three classes of antifungal medications - New York, 2019. MMWR Morb Mortal Wkly Rep, 2020, 69(1): 6-9.
14.	Lyman M, Forsberg K, Sexton DJ, et al. Worsening spread of Candida auris in the United States, 2019 to 2021. Ann Intern Med, 2023, 176(4): 489-495.
15.	U.S. Centers for Disease Control and Prevention. Tracking C. auris. Atlanta: U.S. Centers for Disease Control and Prevention, 2024.
16.	Kohlenberg A, Struelens MJ, Monnet DL, et al. Candida auris: epidemiological situation, laboratory capacity and preparedness in European Union and European Economic Area countries, 2013 to 2017. Euro Surveill, 2018, 23(13): 18-00136.
17.	Kohlenberg A, Monnet DL, Plachouras D, et al. Increasing number of cases and outbreaks caused by Candida auris in the EU/EEA, 2020 to 2021. Euro Surveill, 2022, 27(46): 2200846.
18.	Du H, Bing J, Nobile CJ, et al. Candida auris infections in China. Virulence, 2022, 13(1): 589-591.
19.	Wang X, Bing J, Zheng Q, et al. The first isolate of Candida auris in China: clinical and biological aspects. Emerg Microbes Infect, 2018, 7(1): 93.
20.	Bing J, Du H, Guo P, et al. Candida auris-associated hospitalizations and outbreaks, China, 2018-2023. Emerg Microbes Infect, 2024, 13(1): 2302843.
21.	Xiao M, Zhang L, Wang Y, et al. China’s innovative national plan to combat fungal diseases and antifungal resistance. Innovation (Camb), 2024, 6(1): 100741.
22.	Osei Sekyere J. Candida auris: a systematic review and meta-analysis of current updates on an emerging multidrug-resistant pathogen. Microbiologyopen, 2018, 7(4): e00578.
23.	Akbar Z, Aamir M, Saleem Z. Optimizing antifungal therapy: a systematic review of pharmacist interventions, stewardship approaches, and outcomes. Front Med (Lausanne), 2024, 11: 1489109.
24.	Ji B, Ye W. Prevention and control of hospital-acquired infections with multidrug-resistant organism: a review. Medicine (Baltimore), 2024, 103(4): e37018.
25.	Ahmad S, Asadzadeh M. Strategies to prevent transmission of Candida auris in healthcare settings. Curr Fungal Infect Rep, 2023, 17(1): 36-48.
26.	Sexton DJ, Welsh RM, Bentz ML, et al. Evaluation of nine surface disinfectants against Candida auris using a quantitative disk carrier method: EPA SOP-MB-35. Infect Control Hosp Epidemiol, 2020, 41(10): 1219-1221.
27.	Bruno M, Kersten S, Bain JM, et al. Transcriptional and functional insights into the host immune response against the emerging fungal pathogen Candida auris. Nat Microbiol, 2020, 5(12): 1516-1531.
28.	Chatterjee P, Choi H, Ochoa B, et al. Clade-specific variation in susceptibility of Candida auris to broad-spectrum ultraviolet C light (UV-C). Infect Control Hosp Epidemiol, 2020, 41(12): 1384-1387.
29.	Chow NA, de Groot T, Badali H, et al. Potential fifth clade of Candida auris, Iran, 2018. Emerg Infect Dis, 2019, 25(9): 1780-1781.
30.	Ninan MM, Sahni RD, Chacko B, et al. Candida auris: clinical profile, diagnostic challenge and susceptibility pattern: experience from a tertiary-care centre in South India. J Glob Antimicrob Resist, 2020, 21: 181-185.
31.	Wong RC, Lee AL, Cheung IY, et al. Current updates on molecular diagnostic assays used for detection of Candida auris: a systematic review. Diagnostics (Basel), 2025, 15(2): 140.
32.	孙怀远, 冯佳佳, 孔维华, 等. 耳念珠菌基因组学研究综述. 中国感染控制杂志, 2024, 23(11): 1456-1462.

1. 徐英春, 黄晶晶, 肖盟, 等. 中国耳念珠菌临床感染现状. 协和医学杂志, 2019, 10(5): 442-445.
2. Satoh K, Makimura K, Hasumi Y, et al. Candida auris sp. nov., a novel ascomycetous yeast isolated from the external ear canal of an inpatient in a Japanese hospital. Microbiol Immunol, 2009, 53(1): 41-44.
3. Chowdhary A, Sharma C, Duggal S, et al. New clonal strain of Candida auris, Delhi, India. Emerg Infect Dis, 2013, 19(10): 1670-1673.
4. Lee WG, Shin JH, Uh Y, et al. First three reported cases of nosocomial fungemia caused by Candida auris. J Clin Microbiol, 2011, 49(9): 3139-3142.
5. Magobo RE, Corcoran C, Seetharam S, et al. Candida auris-associated candidemia, South Africa. Emerg Infect Dis, 2014, 20(7): 1250-1251.
6. World Health Organization. WHO fungal priority pathogens list to guide research, development and public health action. Geneva: World Health Organization, 2022.
7. Alanio A, Snell HM, Cordier C, et al. First patient-to-patient intrahospital transmission of clade I Candida auris in France revealed after a two-month incubation period. Microbiol Spectr, 2022, 10(5): e0183322.
8. Huang X, Hurabielle C, Drummond RA, et al. Murine model of colonization with fungal pathogen Candida auris to explore skin tropism, host risk factors and therapeutic strategies. Cell Host Microbe, 2021, 29(2): 210-221.e6.
9. Sikora A, Hashmi MF, Zahra F. Candida auris. Treasure Island: StatPearls, 2025.
10. Kim TH, Kweon OJ, Kim HR, et al. Identification of uncommon Candida species using commercial identification systems. J Microbiol Biotechnol, 2016, 26(12): 2206-2213.
11. Kathuria S, Singh PK, Sharma C, et al. Multidrug-resistant Candida auris misidentified as Candida haemulonii: characterization by matrix-assisted laser desorption ionization-time of flight mass spectrometry and DNA sequencing and its antifungal susceptibility profile variability by Vitek 2, CLSI broth microdilution, and Etest method. J Clin Microbiol, 2015, 53(6): 1823-1830.
12. Spivak ES, Hanson KE. Candida auris: an emerging fungal pathogen. J Clin Microbiol, 2018, 56(2): e01588-17.
13. Ostrowsky B, Greenko J, Adams E, et al. Candida auris isolates resistant to three classes of antifungal medications - New York, 2019. MMWR Morb Mortal Wkly Rep, 2020, 69(1): 6-9.
14. Lyman M, Forsberg K, Sexton DJ, et al. Worsening spread of Candida auris in the United States, 2019 to 2021. Ann Intern Med, 2023, 176(4): 489-495.
15. U.S. Centers for Disease Control and Prevention. Tracking C. auris. Atlanta: U.S. Centers for Disease Control and Prevention, 2024.
16. Kohlenberg A, Struelens MJ, Monnet DL, et al. Candida auris: epidemiological situation, laboratory capacity and preparedness in European Union and European Economic Area countries, 2013 to 2017. Euro Surveill, 2018, 23(13): 18-00136.
17. Kohlenberg A, Monnet DL, Plachouras D, et al. Increasing number of cases and outbreaks caused by Candida auris in the EU/EEA, 2020 to 2021. Euro Surveill, 2022, 27(46): 2200846.
18. Du H, Bing J, Nobile CJ, et al. Candida auris infections in China. Virulence, 2022, 13(1): 589-591.
19. Wang X, Bing J, Zheng Q, et al. The first isolate of Candida auris in China: clinical and biological aspects. Emerg Microbes Infect, 2018, 7(1): 93.
20. Bing J, Du H, Guo P, et al. Candida auris-associated hospitalizations and outbreaks, China, 2018-2023. Emerg Microbes Infect, 2024, 13(1): 2302843.
21. Xiao M, Zhang L, Wang Y, et al. China’s innovative national plan to combat fungal diseases and antifungal resistance. Innovation (Camb), 2024, 6(1): 100741.
22. Osei Sekyere J. Candida auris: a systematic review and meta-analysis of current updates on an emerging multidrug-resistant pathogen. Microbiologyopen, 2018, 7(4): e00578.
23. Akbar Z, Aamir M, Saleem Z. Optimizing antifungal therapy: a systematic review of pharmacist interventions, stewardship approaches, and outcomes. Front Med (Lausanne), 2024, 11: 1489109.
24. Ji B, Ye W. Prevention and control of hospital-acquired infections with multidrug-resistant organism: a review. Medicine (Baltimore), 2024, 103(4): e37018.
25. Ahmad S, Asadzadeh M. Strategies to prevent transmission of Candida auris in healthcare settings. Curr Fungal Infect Rep, 2023, 17(1): 36-48.
26. Sexton DJ, Welsh RM, Bentz ML, et al. Evaluation of nine surface disinfectants against Candida auris using a quantitative disk carrier method: EPA SOP-MB-35. Infect Control Hosp Epidemiol, 2020, 41(10): 1219-1221.
27. Bruno M, Kersten S, Bain JM, et al. Transcriptional and functional insights into the host immune response against the emerging fungal pathogen Candida auris. Nat Microbiol, 2020, 5(12): 1516-1531.
28. Chatterjee P, Choi H, Ochoa B, et al. Clade-specific variation in susceptibility of Candida auris to broad-spectrum ultraviolet C light (UV-C). Infect Control Hosp Epidemiol, 2020, 41(12): 1384-1387.
29. Chow NA, de Groot T, Badali H, et al. Potential fifth clade of Candida auris, Iran, 2018. Emerg Infect Dis, 2019, 25(9): 1780-1781.
30. Ninan MM, Sahni RD, Chacko B, et al. Candida auris: clinical profile, diagnostic challenge and susceptibility pattern: experience from a tertiary-care centre in South India. J Glob Antimicrob Resist, 2020, 21: 181-185.
31. Wong RC, Lee AL, Cheung IY, et al. Current updates on molecular diagnostic assays used for detection of Candida auris: a systematic review. Diagnostics (Basel), 2025, 15(2): 140.
32. 孙怀远, 冯佳佳, 孔维华, 等. 耳念珠菌基因组学研究综述. 中国感染控制杂志, 2024, 23(11): 1456-1462.

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