The CDC has issued a warning about Candida auris, saying the fungus spread at an “alarming rate” in healthcare facilities in 2020 through 2021.
Officials said the number of C. auris cases that were resistant to treatment tripled in 2021. The fungus showed resistance to echinocandins, the antifungal medicine most recommended for treatment of C. auris infections.
C. auris has been deemed an urgent antimicrobial resistance (AR) threat because of its resistance to multiple antifungal drugs, how easily it spreads in healthcare facilities and because it can cause severe infections with high death rates.
“The rapid rise and geographic spread of cases is concerning and emphasizes the need for continued surveillance, expanded lab capacity, quicker diagnostic tests, and adherence to proven infection prevention and control,” said CDC epidemiologist Dr. Meghan Lyman.
What is c. auris? Why is it a concern?
C. auris is a yeast or type of fungus that can spread through contact with affected patients and contaminated surfaces or equipment. It was first reported in the U.S. in 2016.
It can cause serious infections and even death. It is particularly dangerous in hospital and nursing home patients with serious medical problems. Antifungal medicines that are used to treat Candida infections often do not work against C. auris.
“The timing of this increase and findings from public health investigations suggest C. auris spread may have worsened due to strain on healthcare and public health systems during the COVID-19 pandemic.”
Centers for Disease Control and Prevention
C. auris can be difficult to identify with standard laboratory methods and can be misidentified in labs without specific technology.
The most rapid rise in cases occurred from 2020 through 2021 and the CDC continued to see an increase in case counts during 2022. The CDC said case counts have increased for many reasons including, poor general infection prevention and enhanced efforts to detect cases.
How many cases have been in Michigan?
There have been 35 clinical C. auris cases in Michigan since 2021. Clinical cases include both confirmed and probable cases. The data below comes from the CDC.
| Year | Number of C. auris cases |
|---|---|
| 2020 | 0 |
| 2021 | 2 |
| 2022 | 33 |
What are the symptoms of a C. auris infection?
The most common symptoms are fever and chills that don’t improve after antibiotics for a suspected bacterial infection.
C. auris can cause bloodstream infections, wound infections and ear infections. Infections are usually diagnosed by culture of blood or other bodily fluids, but require special laboratory tests.
People who have recently spent time in nursing homes and have lines and tubes that go into their body appear to be at highest risk for C. auris infection. Other risk factors include recent surgery, diabetes and broad-spectrum antibiotic and antifungal use.
Most infections are treatable with echinocandins, but some are resistant to medications which makes them more difficult to treat.
The CDC estimates that 30–60% of people with C. auris infections have died, but that information is based on a limited number of patients. Those patients also had other serious illnesses that increased their risk of death.
How does C. auris spread?
C. auris can spread through contact with contaminated environmental surfaces or from person to person. The CDC said more work is needed to fully understand how it spreads.
The CDC has provided information for healthcare providers and infection control personnel. The CDC is also working with state and local health agencies, healthcare facilities and clinical microbiology laboratories to ensure laboratories are using proper methods to detect C. auris.
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