The China Newsweek has recently reported on the infections of the "superbug"—Candida auris (C. auris) in China. According to Liao Wanqing, an academician of the Chinese Academy of Engineering and professor in the Dermatology Department of Changzheng Hospital, Second Military Medical University, "18 cases of clinical infection with the superbug have so far been confirmed in China." The infections of the superbug have been much concerned by the public due to the high fatality rate (more than 60%) thereof. The U.S. Centers for Disease Control and Prevention (CDC) has listed C. auris as an imminent threat, and the "superbug" control situations are also very severe in the UK, Japan, and India, etc. And as there is still no specific drug, more than 50% "superbug" infected people will die in 90 days. Such severe situations have raised very exigent requirements to the pharmaceutical practitioners.

I. About the "superbug"-C. auris
The scientific name of the "superbug" is C. auris which was first discovered in Japan in 2009 and has thereafter rapidly spread. Countries where the "superbug" has been reportedly separated and obtained include Canada and U.S. in North America, Colombia, Panama, and Venezuela in South America, Germany, France, Norway, Spain, UK, Switzerland, Russia, Belgium, and Austria in Europe, South Africa and Kenya in Africa, and India, Israel, Japan, Kuwait, Oman, Pakistan, South Korea, China, Malaysia, Saudi Arabia, and the United Arab Emirates in Asia. Wherein, Austria, Belgium, China, Malaysia, Norway, Russia, Switzerland, and the United Arab Emirates had all reported one case. This "superbug" has swept the globe.
In terms of the harm, C. auris can infect patients’ blood, lung, urethra, surface wound, and ear canal, etc. The external environmental factors that cause C. auris infections are similar to those that cause other pathogenic candida infections, with the risk factors including inserted catheters (urinary, central venous and arterial catheters), invasive medical procedures and equipment, use of breathing devices, long-term hospitalization, ICU (intensive care unit) patients, continuous treatment with broad-spectrum antifungals or antibiotics or treatment with immunosuppressants, and patients complicated with other diseases like diabetes and HIV. An understanding of the above is of some significance to the prevention of C. auris infection.
II. Drug susceptibility and resistance of the "superbug"
The medication standard of the minimum inhibitory concentration (MIC) of C. auris has still not been established. With reference to the medication standards of other candida, it turns out that almost all strains are highly resistant to fluconazole, more than half are resistant to voriconazole, 1/3 strains are resistant to amphotericin B (MIC≥2μg/mL), and a few strains are also resistant to echinocandins. Researchers have tested the susceptibility of 90 strains of C. auris to the common antifungals through the broth microdilution method recommended by the Clinical and Laboratory Standards Institute (CLSI), it turned out C. auris had high MIC90 values against fluconazole, amphotericin B, 5-fluorocytosine, and caspofungin, separately 64, 4, 8, and 1 μg/mL (Fig. I).










(All Rights Reserved)