Candida Auris: Public Health Threat in Healthcare Facilities

Written on 26 April 2023.

Fungus plays a complex role in our lives. While some forms are harmless or even helpful, others can threaten our health. Medical facilities around the world are dealing with one such fungus known as Candida auris, which has become more threatening in recent years.

Candida auris is increasingly showing up in hospitals and other healthcare facilities. It is spreading globally, causing severe sickness in patients. This article discusses the spread of this public health threat, the symptoms of infection, and how to contain it.

What Is Candida Auris?

Candida auris (C. auris) is an antimicrobial-resistant fungal yeast first discovered in Japan in 2009. Earlier strains date back to 1996 in South Korea. The Centers for Disease Control and Prevention (CDC) designated it an emerging pathogen, given its increased spread throughout many countries.

C. auris can infect wounds, ears, and the bloodstream. Although it is detectable in urine and respiratory mucus, it is still unclear whether this fungal yeast can cause lung or bladder infections.

Like other Candida strains, C. auris is identified by testing blood or other bodily fluids, but it is often more difficult to detect. During diagnosis, it is frequently confused with different yeasts like Candida haemulonii.

C. auris infection is relatively uncommon in the U.S. However, individuals who get infected often are sick with other illnesses, making it difficult to know if the condition is from C. auris. Laboratory tests are needed to diagnose Candida infection. A person with Candida may experience symptoms like chills and fever, which may persist if the patient does not respond to antibiotics for a suspected bacterial infection.

Why Candida Auris Is a Serious Public Health Threat

Since its identification in 2009, C. auris has emerged in at least 28 U.S. states and over 30 countries. In 2022, the U.S. saw 2,377 cases of infection and 5,754 diagnoses in patients with no apparent infection. States with the highest rates include California, Florida, Illinois, Nevada, New York, and Texas.

There are several reasons why Candida infection is becoming widespread, one of which is the difficulty in diagnosis. Another factor is that the strain is often resistant to several antifungal drugs, making it difficult to treat. About 90% of the fungal strains resist at least one drug.

If not diagnosed or treated effectively, this infection can cause serious illness and death. It disproportionately affects older adults and people with compromised immune systems and other severe conditions. Patients with central venous catheters, tubes or lines connected to their bodies, or extended stays in hospitals and nursing homes also tend to be at higher risk for infection. With limited data gathered on this illness, researchers claim that C. auris and other Candida infections have similar risk factors, including diabetes, recent surgery, and the use of broad-spectrum antibiotics and antifungal medications.

Candida infection can be fatal, with 30% to 60% of afflicted people dying. According to the CDC, experts have difficulty pinpointing the fatality rate because the data originate from a limited number of patients. Researchers still do not know if patients infected with C. auris are more likely to succumb to their illnesses than those with other Candida infections.

Another factor contributing to the rapid spread is the lack of conventional and reliable testing methods. Healthcare providers need specialized laboratory testing to identify the C. auris strain. Also, most antifungal drugs that effectively treat most Candida infections do not work on C. auris.

Monitoring, Treatment, and Prevention

The CDC is among many agencies sounding the alarm about the Candida auris threat. Healthcare practitioners, health information educators, and the general public need to know that this infection is resistant to most medications and that people with extended stays in nursing care facilities and hospitals are at risk.

If you suspect that you or someone you know has a fungal or hospital-related infection, contact your doctor immediately. If you or someone you know come in contact with a patient, you can take steps to reduce your risk for infection. Wash your hands with soap and water or use hand sanitizer before and after being with a patient with C. auris in their room. Also, do not hesitate to ask nurses, doctors, and other healthcare staff to keep their hands clean and take extra precautions.

If you or someone you know is a patient with C. auris, try to find a provider with fungal infection experience. Ask about echinocandins, a group of drugs that have effectively treated some Candida cases.

Because C. auris has been prevalent in hospitals and nursing homes, providers, laboratory staff, and other medical professionals in these settings should watch for potential cases. Quick identification of the infection is crucial to containing it and stopping its spread. Anyone identifying a case should report it immediately to the appropriate public health agencies. Healthcare staff can take steps to prevent the spread:

Keep their hands clean and use protective gloves and gowns
Clean patients with disinfectants that work well on C. auris
Disinfect the patient’s environment daily
When transferring patients, alert the new facility about the patient’s status
Continually look for additional measures to contain the strain and prevent spread

Research and materials for this article were compiled, written, and distributed on behalf of the National Public Health Information Coalition. The views and opinions expressed in this blog are those of the various authors and do not necessarily reflect the official policy or position of the National Public Health Information Coalition or its members.

References

https://www.cdc.gov/media/releases/2023/p0320-cauris.html

https://www.cdc.gov/fungal/candida-auris/candida-auris-qanda.html

https://www.cdc.gov/fungal/candida-auris/c-auris-drug-resistant.html

https://thehill.com/homenews/nexstar media wire/3943977-what-are-the-symptoms-of-candida-auris-the-drug-resistant-fungus-spreading-in-28-states/

https://www.npr.org/2023/03/21/1164912425/candida-auris-yeast-fungus-cdc-spread

https://www.cdc.gov/fungal/candida-auris/tracking-c-auris.html

https://www.cdc.gov/drugresistance/pdf/threats-report/candida-auris-508.pdf

https://www.cdc.gov/fungal/candida-auris/c-auris-treatment.html

https://www.cdc.gov/fungal/candida-auris/identification.html

https://www.cdc.gov/fungal/candida-auris/c-auris-infection-control.html