Candida Auris: The CDC Labels The Fungus An “Urgent Antimicrobial Resistance (AR) Threat”

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March 27, 2023

What is Candida auris? 

First identified in 2009, Candida Auris has since then been reported in several countries around the world. C. auris is a type of fungus that can cause fatal infections in humans. What makes C. auris particularly problematic is its ability to resist most anti-fungal medications, which makes it difficult to treat. 

Candida auris infections are most commonly seen in people with weakened immune systems, such as those in hospitals or nursing homes. The fungus can cause an infection in the bloodstream, urinary tract, and other parts of the body. Symptoms of C. auris infections can include fever, chills, and fatigue.  

Why is Candida auris in the news today? 

The Centers for Disease Control and Prevention (CDC) has deemed it an “urgent antimicrobial resistance (AR) threat.” In 2021, the known cases doubled to 1,471, which is likely an underestimate. There are reports of new cases coming in from several states including New York, Pennsylvania, Oregon, Tennessee, and New Jersey. Dr. Syra Madad, an infectious disease epidemiologist at Harvard’s Belfer Center for Science and International Affairs has said, “Current C. auris trends are quite worrying and require a nationwide call to action.” 

What is causing the spread of Candida auris? 

The exact reason for the spread of C. auris is unknown; however, Dr. Madad speculates that climate change might be the culprit for its emergence. Dr. Madad has said, “Global warming, for example, may be leading to better adaptation of C. auris to higher temperatures and ultimately greater susceptibility of infections to humans.” Warmer temperatures allow the fungi to adapt to the high temperatures of the human body. Some contributing factors contributing to the spread include: 

  1. Global travel: C. auris has been identified in multiple countries, and it is believed that international travel plays a role in its spread. 
  2. Hospital transmission: C. auris can survive on surfaces in healthcare facilities and can spread between patients through contact with contaminated surfaces or equipment. 
  3. Misidentification and misdiagnosis: Candida auris can be difficult to identify and can be misdiagnosed as other types of infections, leading to delays in treatment and further spread of the fungus. 
  4. Anti-fungal resistance: C. auris is resistant to many anti-fungal drugs, making it difficult to treat and control. 
  5. Lack of awareness: Healthcare providers may not be aware of the risk of Candida auris and may not take necessary precautions to prevent its spread. 

Who is at risk from Candida auris? 

While Candida auris can infect anyone, there are certain populations that are a higher risk than others. They include: 

  1. People with weakened immune systems such as individuals with weakened immune systems, such as those with HIV/AIDS, cancer, or autoimmune diseases 
  2. Elderly people, especially those in long-term care facilities or nursing homes
  3. People with underlying health conditions such as diabetes or cardiovascular disease, are also at a higher risk of C. auris infection. 
  4. Hospitalized patients, especially those who have been on antibiotics or other medications that weaken the immune system
  5. People with invasive medical devices, such as central venous catheters or urinary catheters 
  6. People who have had recent surgery, especially those who have undergone surgery in healthcare facilities with a high prevalence of Candida auris
  7. People who have been in contact with infected individuals

Candida auris is still a relatively new pathogen. There is still much more to learn about its transmission and risk factors. 

Why the elderly are especially at risk from Candida auris? 

The elderly are at a higher risk of a  C. auris infection because they often have weakened immune systems and are more susceptible to infections. Candida auris is an opportunistic pathogen, which means that it takes advantage of those with weakened immune systems. The elderly might also have underlying health conditions or be taking medications that further weaken their immune system, which will also make them more vulnerable to infections. 

In addition, the elderly may also have more frequent hospitalizations and medical procedures, which can increase their risk of exposure to Candida auris. C. auris can survive on surfaces and can spread between patients through contact with contaminated surfaces or equipment, making healthcare facilities a high-risk environment for infection transmission. 

Furthermore, elderly individuals are also more likely to have comorbidities, such as diabetes or cardiovascular disease, that can increase their risk of Candida auris infection. These comorbidities may also make the infection more severe and increase the risk of complications. 

How to prevent the spread of Candida auris? 

Preventing the spread of C. auris requires a multi-faceted approach that involves several key strategies. Here are a few things healthcare facilities and civilians alike can take: 

  1. Early detection: Early detection of Candida auris infections is crucial to preventing its spread. Healthcare providers should be aware of the signs and symptoms of the infection and be vigilant in testing patients who may be at risk. 
  2. Strict infection control measures: Healthcare facilities should implement strict infection control measures, such as isolating infected patients, using contact precautions, and maintaining proper hand hygiene. 
  3. Environmental cleaning: C. auris can survive on surfaces in healthcare settings, so thorough and frequent environmental cleaning is important to prevent its spread. 
  4. Anti-fungal stewardship: Overuse of anti-fungal medications can contribute to the development of drug-resistant strains of Candida auris. Anti-fungal stewardship programs can help to ensure that anti-fungal medications are used appropriately and only when necessary. 
  5. Education and awareness: Healthcare providers and the public should be educated about the risks of C. auris and how to prevent its spread. This can include information about infection control measures, early detection, and proper use of anti-fungal medications. 

By taking these measures, we can work to prevent the spread of Candida auris and protect the health of vulnerable populations. 

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