Not quite a year and a half ago (June 24th, 2016) the CDC issued a Clinical Alert to U.S. Health care facilities about the Global Emergence of Invasive Infections Caused by the Multidrug-Resistant Yeast Candida auris.
C. auris is an emerging fungal pathogen that was first isolated in Japan in 2009. It was initially found in the discharge from a patient's external ear (hence the name `auris'). Retrospective analysis has traced this fungal infection back over 20 years.Since then the CDC and public health entities have been monitoring an increasing number of cases (and hospital clusters) in the United States and abroad, generally involving bloodstream infections, wound infections or otitis (see September update).
Adding to the concern:
- C. auris infections have a high fatality rate
- The strain appears to be resistant to multiple classes of anti-fungals
- This strain is unusually persistent on fomites in healthcare environments.
- And it can be difficult for labs to differentiate it from other Candida strains
Last last week the CDC updated their C. Auris surveillance page, where they now show 157 confirmed cases and 29 probable cases, across 10 states (California was added this month). The number of colonized asymptomatic cases has risen to 212.
Candida auris is an emerging fungus that presents a serious global health threat. C. auris causes severe illness in hospitalized patients in several countries, including the United States. Patients can remain colonized with C. auris for a long time and C. auris can persist on surfaces in healthcare environments. This can result in spread of C. auris between patients in healthcare facilities.While the number of confirmed and probable clinical cases continues to climb at a steady rate, the largest increase over the past few months has been in the number of colonized asymptomatic carriers detected via targeted screening.
Most C. auris cases in the United States have been detected in the New York City area and New Jersey. Strains of C. auris in the United States have been linked to other parts of the world. U.S. C. auris cases are a result of inadvertent introduction into the United States from a patient who recently received healthcare in a country where C. auris has been reported or a result of local spread after such an introduction.
Last August the CDC promoted the first ever Fungal Disease Awareness Week, and presented a COCA call webinar called Tackling an Invasive, Emerging, Multi-drug Resistant Yeast: Candida auris — What Healthcare Providers Need to Know, which is now archived and available online.
CIDRAP's Antimicrobial Stewardship Project (ASP) also held an hour long webinar (see below), which is now available on the CIDRAPASP Youtube channel.
(Note: you'll find more than a dozen other on-topic videos available on this channel as well).For more on this emerging fungal pathogen, you may wish to revisit:
MMWR: Investigation of the First Seven Reported Cases of Candida auris In the United States
mSphere: Comparative Pathogenicity of UK Isolates of the Emerging Candida auris