{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T08:13:39Z","timestamp":1788164019877,"version":"build-2803163510"},"reference-count":56,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      This study systematically evaluated the antifungal resistance profile of\n                      <jats:italic>Candida auris<\/jats:italic>\n                      (\n                      <jats:italic>C. auris<\/jats:italic>\n                      ) to five antifungal agents in mainland China, and analyzed clinical outcomes in a combined cohort of patients with\n                      <jats:italic>C. auris<\/jats:italic>\n                      colonization or infection. It aims to provide evidence-based references for clinical antifungal management and nosocomial infection prevention and control.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Six databases, including PubMed, Web of Science, and Embase, were systematically searched to identify observational studies reporting antifungal susceptibility of\n                      <jats:italic>C. auris<\/jats:italic>\n                      isolates and clinical outcomes of corresponding patients in mainland China. Meta-analysis was adopted to pool the resistance rates and multidrug resistance (MDR) rate of five antifungal agents. Meanwhile, we summarized the overall rate of poor prognosis, in-hospital mortality rate, and rate of clinical deterioration at discharge for patients with detected\n                      <jats:italic>C. auris<\/jats:italic>\n                      . Funnel plots and Egger\u2019s test were used to assess publication bias.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      <jats:italic>C. auris<\/jats:italic>\n                      in mainland China exhibited extremely high resistance to fluconazole, with a pooled resistance rate of 98% (95%CI: 93%\u2013100%). Echinocandins maintained favorable overall susceptibility. The resistance rates of caspofungin, micafungin, and anidulafungin were 3% (95%CI: 0%\u201311%), 2% (95%CI: 0%\u20134%), and 1% (95%CI: 0%\u20133%), respectively. The resistance rate of\n                      <jats:italic>C. auris<\/jats:italic>\n                      to amphotericin B was 34% (95%CI: 12%\u201361%). The pooled MDR rate was 60% (95% CI: 16%\u201397%). The overall poor prognosis rate of patients with\n                      <jats:italic>C. auris<\/jats:italic>\n                      isolation was 43% (95%CI: 23%\u201364%). The in-hospital mortality rate was 24% (95% CI: 12%\u201338%), while the rate of clinical deterioration at discharge was 23% (95% CI: 5%\u201346%). No significant publication bias was observed in this study.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Fluconazole is not an appropriate choice for treating\n                      <jats:italic>C. auris<\/jats:italic>\n                      strains in mainland China, while echinocandins should be the primary treatment option. Amphotericin B should be administered cautiously based on antifungal susceptibility testing. The pooled MDR rate was relatively high. Patients with\n                      <jats:italic>C. auris<\/jats:italic>\n                      colonization or infection exhibit variable clinical outcomes. Clinical practice should prioritize routine laboratory antifungal susceptibility surveillance, standardized hospital infection control measures, and targeted interventions to improve patient clinical outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmicb.2026.1888683","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T07:15:25Z","timestamp":1788160525000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Antifungal resistance and poor clinical outcome rates of Candida auris in mainland China: A systematic review and meta-analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Tao","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory, Xianyang Central Hospital, Xianyang","place":["Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Xianyang Central Hospital, Xianyang","place":["Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yufang","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Xianyang Central Hospital, Xianyang","place":["Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Reproductive Medicine, Xianyang Central Hospital, Xianyang","place":["Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"myaf107","DOI":"10.1093\/mmy\/myaf107","article-title":"Global prevalence of multidrug-resistant Candida auris in humans between 2015 and 2024: A systematic review and meta-analysis.","volume":"63","author":"Achilonu","year":"2025","journal-title":"Med. 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