Expert explains the concern around Candida auris
Candida auris, or C. auris, is a name you might not yet be familiar with but is an increasingly common topic in the news.
So, what is it?
To learn more, we talked to infectious disease specialist and epidemiologist Karen Brust, MD.
- Candida auris (C. auris) is a type of yeast that can cause severe illness and spreads among patients in health care facilities.
- Symptoms of C. auris depend on the type of infection (i.e., bloodstream, wound, urine).
- C. auris is often resistant to antifungal medications (drugs used to treat and prevent fungal infections).
- Healthy people typically do not get C. auris.
What is C. auris?
C. auris, or Candida auris, is a type of yeast that can cause severe illness. It can easily spread among patients in health care facilities, but lately we've seen that long-term care facilities and ventilator-capable skilled nursing facilities in the U.S. are particularly vulnerable.
What are the symptoms?
C. auris can cause a range of infections from mild to moderate superficial skin infections to more severe, life-threatening cases, such as bloodstream infections. Although there isn’t a common set of symptoms for C. auris, people usually show signs based on which organ system it is infecting. For example, an infected wound may worsen and have increased drainage, and the patient may have a fever.
How does it spread?
There are two types of patients with C. auris to keep in mind: Patients who are infected and patients who are colonized with C. auris. Both types of individuals can spread it through shed skin cells onto surfaces, objects, and to others. C. auris can survive on surfaces for weeks, exposing and possibly infecting those who enter the environment.
When we refer to someone’s infection as “colonized,” what we mean is that they have C. auris on their skin and/or other parts of their body without having any symptoms. It’s important to note that those who are colonized can still spread C. auris to others.
What is the treatment?
The treatment options we have are limited and should be determined in consultation with an infectious disease consultant. Drugs that we would typically use to treat fungal infections, like Azoles, are usually ineffective. Our current primary treatment is a unique class of antifungal drugs called Echinocandins.
How is C. auris detected?
Candida auris can be difficult to identify and is sometimes misidentified as a similar yeast like Candida haemulonii. For the past decade, our microbiology lab has been able to differentiate C. auris from other types of Candida yeasts. Many other laboratories either do not routinely identify yeast or do not use a method capable of identifying C. auris.
Why are we concerned about C. auris?
C. auris is one of those things that, as an epidemiology and infection prevention team, we watch very closely for three primary reasons: It is highly drug-resistant, it can be difficult to identify, and it has the potential to spread in health care settings.
Once a patient becomes colonized, they could then become infected and have few treatment options. If a patient becomes fungemic, meaning there is yeast in their blood, there is nearly a 50% chance of mortality.
If a patient has C. auris, contact precautions like using appropriate personal protective equipment and proper hand hygiene are required and can help us stop the spread of the infection.
For most healthy people, C. auris is not a threat. It primarily impacts those with severe underlying medical conditions and those requiring complex medical care and invasive medical devices.
If you’re a healthy person without a risk factor, it’s unlikely you would get C. auris. The CDC typically does not recommend screening or testing health care employees or family members of patients with C. auris.
What is UI Health Care doing to prevent and monitor C. auris?
We’re currently screening our high-risk admitted patients to learn what the rate of C. auris colonization and infection is across Iowa. We’re also testing patients in long-term care facilities and ventilator-capable skilled nursing facilities, as well as those with who carry certain drug-resistant bacteria and those who recently had an international hospitalization.
We’re also updating the cleaning products used across our organization to ensure rooms are properly disinfected and safe for patients.
The U.S. is seeing a rise in C. auris infections, mostly in individuals with severe underlying medical conditions or those who require complex medical care. However, we all can do our part in helping contain the spread.