Watch Out for Candida auris – Traveling Incognito in Healthcare Settings

February 21, 2023

Written by Vivian Lei

Spoon Feed
Candida auris is an emerging, serious, multi-drug resistant fungal pathogen that can quickly spread in hospitals and long-term care facilities. Consider this in recently hospitalized patients or nursing home residents with a history of C. auris infection or colonization, as they may require appropriate infection control measures, testing, and treatment.

Why does this matter?

• C. auris is classified by the CDC and the WHO as one of the most serious fungal global health threats.
• Fungal pathogens are generally neglected in research funding, clinical surveillance, and medical training, leading to a lack of awareness in the medical community.
• Evidence suggests that climate change and increasing longevity of certain immunocompromised populations are contributing to the rising threat of fungal pathogens.

Candid Candida

What is C. auris?

• C. auris was first identified in 2009 in a specimen taken from an infected ear in Japan, but it has since been reported in more than 55 countries.
• 90 – 95% of patients colonized with C. auris are asymptomatic but can transmit the infection to others.
• C. auris infection usually presents as fever and chills not responding to antibacterial agents and is seen most often in patients with, “serious underlying medical conditions who have received multiple antibiotics, and who have had prolonged admissions to healthcare settings or reside in healthcare settings [see CDC link below].”
• The mortality rate of invasive C. auris candidiasis is as high as 60%.
• C. auris is viable for at least 2 weeks on plastic surfaces and for months on the skin.

Why is it a problem?

• C. auris can quickly spread through contact with contaminated environmental surfaces, medical equipment, fomites, or from person to person.
• Standard laboratory identification methods for C. auris are typically insufficient and can lead to misidentification.
• In the U.S., approximately 30% of C. auris isolates are resistant to amphotericin B, 90% are resistant to fluconazole, and <5% are resistant to echinocandins. Some C. auris strains have been resistant to all 3 available classes of antifungals.

What can be done?

• High-risk patients should be screened for colonization, with swabs of the axilla and groin.
• Health care facilities should consider cohorting colonized and infected patients, instituting infection control measures such as gowns and gloves for healthcare providers and cleaning with specific fungicidal agents.

Another Spoonful
To learn more, see this from the CDC.

Source
On the Rise, Candida auris Outwits Treatments and Travels Incognito in Health Care Settings. JAMA. 2023 Jan 17;329(3):197-199. doi: 10.1001/jama.2022.17760.