Early identification of Candida auris, a potentially deadly fungus that causes bloodstream and intra-abdominal infections, is the key to controlling its spread. Its emergence has highlighted gaps in fungal identification capacity in the U.S. and around the world, and physicians should be on alert for risk factors. A commentary is published in Annals of Internal Medicine.
Candida auris is different from more familiar Candida species in several ways and its drug resistance is unprecedented among known human-pathogenic yeasts. Most Candida species are not believed to be transmitted in health care settings and do not require infection control measures when a patient develops an infection. However, unlike other Candida species, C auris is commonly transmitted between patients in health care settings, causing outbreaks that not only affect a single facility but also spread through networks of facilities. The ability of C auris to persist in and contaminate the health care environment and medical devices likely contributes to these outbreaks.
According to experts from the Centers for Disease Control and Prevention (CDC), previous hospitalization in a country with C auris transmission is a known risk factor for infection or colonization, as is receiving of health care in long-term acute care hospitals and nursing homes that take care of very sick patients who need long-term ventilators. Frequent hospitalizations and receiving of multiple courses of very-broad-spectrum antibiotics are also important risk factors. The authors suggest that being on high alert for these risk factors and screening appropriate patients is the key to controlling the spread of C auris.