CDC Update: Candida Auris Detections Nearly Triple In 2018

Credit CDC



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In June of 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.

By the end of 2017, the number of known U.S. Candida Auris infections was hovering around 200 across 10 states, with roughly another 300 people found to be asymptomatically colonized with C. auris by targeted screening in four states with clinical cases.

Over the past 12 months, those numbers have nearly tripled, with the CDC's latest update (through December 31st, 2018) pushing the number of confirmed case over 500, and with nearly 1,000 others asymptomatically colonized. 

As detection is difficult, and screening is limited - and up until this year C. auris wasn't a notifiable disease - all of these numbers significantly under-represent the true burden of this emerging fungal infection. 

The CDC has published their November update on their  C. Auris surveillance page, where they show - as of December 31st  - 520 confirmed cases and 30  probable cases, across 12 states.

New York, New Jersey, and Illinois continue to lead the pack, making up 95% (n=498) of the 520 confirmed cases. Additionally, 975 patients have been found to be colonized with C. auris by targeted screening conducted in six states with clinical cases.

Tracking Candida auris

January 22, 2019: Case Count Updated as of December 31, 2018

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.

Most C. auris cases in the United States have been detected in the New York City area, New Jersey, and the Chicago area. 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.

Candida auris was made nationally notifiable at the 2018 Council for State and Territorial Epidemiologists (CSTE) Annual Conference. For the updated case definition and information on the nationally notifiable condition status, which will go into effect in 2019, please see the 2018 CSTE position statement[PDF – 16 pages].

 

 Adding to the concern:

1. C. auris infections have a high fatality rate
2. The strain appears to be resistant to multiple classes of anti-fungals  
3. This strain is unusually persistent on fomites in healthcare environments.
4. And it can be difficult for labs to differentiate it from other Candida strains

As depicted the the following CDC map, C. auris is very much a global problem, although limited surveillance prevents us from knowing just how widespread this fungal infection really is.

And some past blogs include:

Notes from the Field: Surveillance for Candida auris — Colombia, September 2016–May 2017)

ECDC: C. Auris Rapid Risk Assessment For Healthcare Settings - Europe

mSphere: Comparative Pathogenicity of UK Isolates of the Emerging Candida auris