Hospital-acquired infections are not uncommon. They are a healthcare challenge because they can lead to complications that slow recovery from other health conditions. Fungal infections can affect people who are recovering from illness, injury, or surgery. Many fungal infections are treatable, but a new strain of microscopic fungus called Candida auris is more difficult to manage.
What Is Candida Auris?
Candida auris, also called C. auris, is a microscopic fungus in the Candida family. Candida is a type of yeast. There are many species of Candida microorganisms. Many of them live on your skin or inside your body and don’t cause any problems. At times, Candida can multiply too much and cause an infection. Vaginal yeast infections are an example of a common Candida infection.
C. auris is a novel, or new, strain of Candida fungus. It was first identified in 2009. It primarily affects people who are in a hospital or nursing facility being treated for other health conditions. It’s relatively rare in the United States, but it is a growing concern in other regions, including Asia, Africa, and South America.
Most people have some Candida on their bodies all the time, along with billions of other microorganisms that make up the microbiome. Unlike other types of Candida, C. auris is not typically present in people. Candida auris infections happen after being exposed to the pathogen, as opposed to the pathogen suddenly increasing in number on your body.
C. auris is difficult to treat because it is resistant to many drugs typically used for fungal infections. If the infection spreads to the bloodstream or internal organs, it can be fatal. As many as one in three people with invasive C. auris infections die.
Candida Auris Causes
Healthy people are typically not at risk of getting a C. auris infection. It’s considered a nosocomial infection, which means it mainly occurs in hospitals or nursing facilities. People who get a C. auris infection are exposed to it when they are already sick. Their bodies are less able to fight off additional infections, so the C. auris organisms can multiply and cause illness.
People with certain medical conditions may be more susceptible to C. auris. Risk factors include:
- Having a central venous catheter
- Having a urinary catheter
- Immunosuppression due to conditions such as HIV, cancer treatment, or being on anti-rejection medicine after an organ transplant
- Diabetes mellitus
- Chronic kidney disease
- Previous use of antibiotics or anti-fungal agents within 30 days
- Blood transfusion
- Hemodialysis
- Surgery within the past 30 days
- Treatment in an intensive care unit
Candida Auris Transmission
Candida auris generally spreads by skin contact with the pathogen. It’s often transmitted from person to person, such as when healthcare staff inadvertently have it on their hands or clothing. They can pass the C. auris to a patient while caring for them.
It’s possible to get infected from touching an object with C. auris on it. The organism can linger on hard surfaces like counters and doorknobs and on other surfaces like blood pressure cuffs, bedding, ventilator tubes, and other medical equipment. It can live for a long time on these surfaces, which increases the risk that it will transmit between people.
The ease of transmission for C. auris can lead to outbreaks of infections in hospitals or nursing care facilities. Patients or staff can pass it to one another. People can be exposed via surfaces or furniture.
Candida Auris Symptoms
C. auris infections affect people who are already sick, so it can be hard to identify which symptoms are caused by the infection. Symptoms depend on which part of the body is infected. C. auris infections have similar symptoms to bacterial infections or other fungal infections, including:
- Myocarditis (inflammation of the heart)
- Urinary tract infection
- Surgical wound infection
- Burn infection
- Abscesses at catheter insertion sites
- Ear infection
- Meningitis
- Bone infection
Candida auris can also cause bloodstream infections. The most common symptoms when that happens are chills and a fever.
Candida Auris Diagnosis
Because C. auris infections are similar to other types of infections, they may not be recognized at first. The only way to definitely diagnose C. auris is by taking a culture from the affected part of the body. After that, lab tests can identify the pathogen causing the infection.
Even lab testing isn’t always perfectly accurate. Because this is a novel pathogen, identifying it can be a challenge. Existing testing methods can misidentify Candida auris as other types of Candida, complicating diagnosis and treatment.
Candida Auris Treatment
Treating Candida auris is challenging because it can be resistant to anti-fungal medications. A class of antifungal medications called echinocandins is the most effective at treating C. auris infections. Many people recover after taking this medication for their infections.
One study of C. auris found that as many as 25% of cases are resistant to multiple types of antifungal medications. When that occurs, doctors typically prescribe a combination of antifungals, sometimes at very high doses. There isn’t a set protocol for treating drug-resistant C. auris, so doctors manage it on a case-by-case basis.
Candida Auris Prevention
Experts suggest that preventing the spread of C. auris is the best course of action. Staff and visitors at hospitals and nursing facilities should wash their hands frequently. Cleaning surfaces and medical equipment thoroughly can also reduce the risk of transmission.
When an individual has a diagnosed C. auris infection, the care facility may need to take precautions to prevent additional spread. Precautionary measures may include:
- Moving the individual to a different room where they have less contact with other patients
- Requiring healthcare personnel and visitors to wear gowns and gloves
- Employing different cleaning methods or products than usual when cleaning the patient's room or any medical equipment used for their care
- Encouraging family members and healthcare personnel to clean their hands thoroughly after any interaction with the individual
If you have concerns about a Candida auris infection, talk to your doctor or other medical staff in your hospital or care facility.