In March 2023, the Centers for Disease Control and Prevention (CDC) issued a warning about the fungus Candida auris (C. auris).
According to the CDC, C. auris is a “serious global health threat.” It has spread rapidly over the last few years in health care facilities and long-term hospitals in several countries. CDC data show there were almost 2,400 clinical cases of C. auris in the U.S. in 2022 — nearly five times the total from 2019.
C. auris can cause severe illness and death in hospitalized patients. It can also resist multiple classes of antifungal drugs, which is another concern.
“The urgency now, even though Candida auris is ’emerging,’ is that this is our chance to keep it rare,” says Graham Snyder, MD, medical director, Infection Prevention and Hospital Epidemiology, UPMC. “Which means that we have to be prepared to recognize it, diagnose it, and prevent its spread.”
Learn more about C. auris, including how it spreads, who is at risk, and treatment options.
What Is Candida Auris?
C. auris is a yeast, which is a type of fungus. Candida is a family of yeasts, of which C. auris is a member. The most well-known Candida yeast is Candida albicans, which lives on or inside your body.
Like other Candida yeasts, C. auris can cause infections in different parts of the body, such as vaginal infections, ear infections, or wound infections. More seriously, it can cause bloodstream infections.
What makes C. auris unique is its recent emergence. Scientists first discovered it in 2009, and it didn’t reach the United States until several years after that. C. auris has not yet spread to every state in the U.S.
The number of clinical cases of C. auris has grown over the past few years. According to CDC data, cases grew from 478 in 2019 to close to 2,400 in 2022.
“It’s emerging,” Dr. Snyder says. “The CDC report that recently came out is highlighting and is raising the alarm that it is spreading relatively rapidly.”
How Does Candida Auris Spread?
C. auris spreads through direct contact. That may include human-to-human contact or contact between a human and a contaminated object. For example: If C. auris is on a patient’s skin and a health care worker touches them and doesn’t wash their hands well enough, that can cause C. auris to spread.
Unlike respiratory viruses, C. auris cannot spread through the air. That means it is unlikely to spread as quickly or cause the number of illnesses as a respiratory virus like SARS-CoV-2, Dr. Snyder says.
The recent spread of C. auris is happening mostly in health care settings, “particularly in environments where people are very sick,” Dr. Snyder says. That includes environments like skilled nursing facilities or situations in which a patient is on a ventilator.
Who’s at Risk for Candida Auris?
Most of the current Candida auris infections are happening in health care settings like hospitals and long-term care facilities. Because of that, people in those environments are most at risk. People with lines and tubes — like breathing or feeding tubes or catheters — appear to have the highest risk, according to the CDC.
Like many other infections, people with compromised immune systems or underlying health conditions also could be at risk. Those could include older adults and people who’ve recently had surgery, have diabetes, or are on antibiotic or antifungal medications.
The CDC notes that people of any age can develop C. auris infections. And although most of the current spread is happening in health care settings, it is possible for C. auris to spread in other environments. For example, methicillin-resistant Staphylococcus aureus (MRSA) began as a threat predominantly found in hospitals but can now commonly occur in the community.
“Candida auris is being transmitted because of outbreaks in hospitals and skilled nursing facilities,” Dr. Snyder says. “It’s very unlikely that you’re going to encounter it in the gym right now or in the grocery store. Outbreaks are predominantly happening in health care settings. That may change over time.”
What Infections Does Candida Auris Cause?
C. auris can cause a wide spectrum of infections. Some people may not get an infection at all after exposure. Infections can vary in severity, from mild to life-threatening. Common infections include:
- Abdominal infections
- Bloodstream infections
- Ear infections
- Vaginal infections
- Wound infections
The most serious of these infections are bloodstream and abdominal infections, Dr. Snyder says.
The CDC reports that it has found C. auris in respiratory and urine samples. But whether C. auris can cause respiratory or bladder infections remains unknown.
How Are Candida Auris Infections Diagnosed?
Blood or other body fluid cultures can diagnose C. auris infections. But because C. auris is like other members of the Candida family, diagnosing it can prove difficult. The CDC says special laboratory methods are necessary for diagnosis.
Proper diagnosis is necessary because without it, incorrect treatment may result.
Are Candida Auris Infections Treatable?
There are only several types of drugs to treat fungal infections. The antifungal medications used to treat serious Candida infections include:
- Azole-class antifungals
- Echinocandin-class antifungals
- Amphotericin
One particular problem with C. auris is that it may have developed resistance to one or more of those drug classes. That can make it harder for treatment to work. The CDC says the number of cases in which that’s happening is increasing.
“What the CDC is highlighting is that while Candida auris was commonly resistant to at least one of those when it emerged, we’re now seeing more and more cases in which it may be resistant to two of those drug classes,” Dr. Snyder says. “Cases have been identified in which Candida auris was resistant to all three drug classes.”
Should I Be Worried About Candida Auris?
Right now, C. auris is still rare. The biggest areas of concern are hospitals, long-term care facilities, and other health care facilities. The risk to the general public is low.
UPMC has prepared against C. auris. Our doctors have prepared to treat people with C. auris infections, and we are taking every step to prevent C. auris transmission in all of our environments. We have committed to protecting our patients, staff, and the community from C. auris.
Dr. Snyder says people should follow updates from the CDC and other health officials. Also, he says, C. auris shouldn’t keep you from seeking medical care.
“Somebody who is generally well should have very little worry about it right now because it’s unlikely to impact your life,” Dr. Snyder says. “Right now, it’s important for you to know about it and listen to the CDC if conditions evolve.
“In particular, Candida auris should not be a reason for you not to seek health care. It’s not a reason not to go to your doctor, not to get your routine colonoscopy or mammogram, not to get a surgery for your knee replacement. You should continue to seek care.”
Editor's Note: This article was originally published on , and was last reviewed on .
Sources
Centers for Disease Control and Prevention, General Information About Candida Auris. Link
Centers for Disease Control and Prevention, Tracking Candida Auris. Link
Jennifer Hassan and Fenit Nirappil, The Washington Post, A Deadly Fungal Infection Is Spreading in Hospitals. Here's What to Know. Link
Matt Richtel, The New York Times, Deadly Fungus Spread Rapidly During the Pandemic, CDC Says. Link