The Centers for Disease Control and Prevention (CDC) has issued a warning about a drug-resistant strain of fungus, Candida auris (C. auris), spreading in health care facilities in the United States.
The CDC identified C. auris as an urgent threat because it is often resistant to treatment with antifungal drugs and can cause severe infections with high death rates.
Although still rare in the U.S., more than 1 in 3 patients with an invasive C. auris infection die from the disease.
In general, the fungus is not a threat to healthy people. People who are very sick, or who have long or frequent stays in health care facilities or a weakened immune system are at increased risk for acquiring C. auris.
People with invasive medical devices, such as catheters, breathing tubes and feeding tubes, are also more vulnerable.
The fungus can cause a bloodstream infection. Fever, chills, sweats and low blood pressure are the most common symptoms of a C. auris infection. Infections have been found in patients of all ages, from preterm infants to the elderly.
C. auris can live on surfaces for several weeks. It spreads in health care settings like hospitals and nursing homes through contact with contaminated surfaces or equipment or from person to person.
Cases have increased significantly in the U.S.
The fungal infection was first reported in 2016. In 2017, according to CDC tracking, there were 173 cases in the U.S. and one case in California. In 2022, those numbers had risen to 2,377 cases across the U.S., with 359 of those in California. The CDC published data on the worsening spread of C. auris in the U.S. in a new paper.
Knowing that infections were increasing, the UC Davis Department of Pathology and Laboratory Medicine went through the process of having a C. auris test validated. This allows UC Davis to test for the fungal infection in-house.
“The good news is that UC Davis Health has not seen a large uptick in C. auris infections at its health care facilities. Since launching the test in September 2021, we have identified C. auris in two patients,” said Nam Tran, a professor and senior director of clinical pathology at UC Davis Health.
Although UC Davis Health is not seeing a spike in cases, Tran is aware of the threat of C. auris to public health. “We will continue to monitor the levels of C. auris infections at our facilities and in the state,” Tran said.
The good news is that UC Davis Health has not seen a large uptick in C. auris infections at its health care facilities.”-Nam Tran, Professor and Senior Director of Clinical Pathology
Infection resistant to many antifungal drugs
Most C. auris infections are treatable with antifungal drugs. However, some strains are drug-resistant.
“This means the first line treatment options may fail, as the fungus is resistant to the therapy,” explained George Thompson, who specializes in caring for patients with invasive fungal infections.
Thompson is a professor at the UC Davis School of Medicine in the Department of Internal Medicine, Division of Infectious Diseases, and the Department of Medical Microbiology and Immunology.
Thompson led clinical trials for REZZAYOTM, a new treatment for invasive fungal infection recently approved by the FDA.
He notes that fungi are more complex organisms than bacteria and viruses and can be difficult to treat. “They have similar cellular machinery to that of humans. This is why medications that kill fungi often have side effects for people,” Thompson said.
The CDC notes that C. auris cases have increased for many reasons, including poor general infection prevention and control practices in health care facilities. The numbers may also have increased because of enhanced efforts to detect cases.
“The rapid rise and geographic spread of cases is concerning and emphasizes the need for continued surveillance, expanded lab capacity, quicker diagnostic tests, and adherence to proven infection prevention and control,” said CDC epidemiologist Meghan Lyman, lead author of the new paper.