What You Need to Know About C. Auris

There’s a new germ in town and it’s not as “sweet” as its name might imply. Candida auris, a type of yeast (a type of fungus), can cause severe illness, or even death, in hospitalized patients. This yeast, referred to as C. auris, can enter the bloodstream and spread through the body. Unfortunately, it often doesn’t respond to commonly used antifungal drugs, making it hard to treat. Learn what you need to know about C. auris so you can protect yourself.

What do you need to know about C. auris?

First and foremost, realize this is a potentially deadly fungus that is spreading throughout the US. The Centers for Disease Control and Prevention (CDC) is concerned about C. auris for these reasons:

1. It is often resistant to multiple antifungal drugs commonly used to treat other Candida infections. Some strains are resistant to all 3 major classes of antifungal drugs.
2. It is hard to identify with standard laboratory methods. Therefore, lab staff without the correct technology can misidentify the specimen. And misidentification may lead to inappropriate treatment and management.
3. C. auris can persist on surfaces in healthcare environments and spread between patients in healthcare facilities, unlike most other Candida species. There have been outbreaks in healthcare settings, making rapid identification of C. auris in a hospitalized patient particularly important so the hospital can take steps to stop its spread.

The news on C. auris just got worse!

In July 2021, the CDC reported that for the first time ever, patients carried or were infected with C. auris infections that were resistant to all major classes of antifungal drugs. Moreover, these patients, in 2 different healthcare facilities, had never received any antifungal treatment before their C. auris infections.

This means the strain of C. auris they caught was already resistant to all antifungal drugs. Experts state this development is “particularly unnerving”, since it could lead to a greater proportion of patients developing untreatable infections. (Read more on treatment options below.)

How common is C. auris?

Unfortunately, the number of cases of C. auris is growing rapidly. According to the CDC, there have been over 1,700 confirmed cases in the US since 2013, across 22 states, with the rise in cases as follows:

How do doctors treat patients with C. auris?

There are only three classes of antifungal drugs used for treating C. auris infections — azoles, polyenes, and echinocandins. However, 85% of C. auris cases detected in the US are resistant to azoles, and 38% are resistant to polyenes. Fortunately, 99% of US cases have responded to echinocandin drugs, so doctors try these medications first for C. auris infections.

Who is at risk for C. auris? 

According to the CDC, people who have recently been patients in nursing homes and have lines and tubes that go into their body (such as breathing tubes, feeding tubes and central venous catheters), seem to be at highest risk for C. auris infection.

Limited data suggest that other risk factors include recent surgery, diabetes, broad-spectrum antibiotic and antifungal use.

Additionally, people in contact with infected patients are also at risk of developing a C. auris infection.

According to the CDC, further study is needed to learn more about risk factors for C. auris infection.

Is age a risk factor?

C. auris infections have been found in patients of all ages, from preterm infants to the elderly.

What are the signs and symptoms of C. auris?

Like other pathogens, C. auris can cause bloodstream infections, wound infections, and ear infections.

Unfortunately, C. auris can be hard to detect because it often happens in patients who are very ill.  However, if a patient develops a fever and chills that don’t improve with a normal course of antibiotics, it might be C. auris.

If this happens to your loved one, ask for a C. auris test.

How can the spread of C. auris be controlled?

To prevent the spread of germs, proper hand hygiene among medical staff must be practiced. As hard as it is to believe, many doctors and other staff members are not washing their hands regularly.

A 2014 study found that less than 1/3 of healthcare workers in an ICU (intensive care unit) always washed their hands. Why aren’t they washing their hands frequently enough? It’s likely a combination of forgetfulness and apathy.

To reduce the risk of transferring the infection among patients, those infected with C. auris should be isolated in single rooms. Additionally, staff should wear gowns and gloves when treating infected patients, and should use medical equipment dedicated to each infected patient. Thorough environmental cleaning of hospital rooms may help as well.

What can you do?

Now that you know more about C. auris, you can take steps to reduce your risk of infection:

• Practice good hand hygiene:
  • Everyone, including medical staff and patients, should wash their hands frequently. Use alcohol-based hand sanitizer or wash with soap for 40-60 seconds.
  • If you don’t see a medical provider wash their hands and/or put on clean gloves before patient contact, speak up! This can be awkward, but it is important.
• Bring your own bleach-containing wipes to the hospital and use them regularly. Clean all surfaces in a hospital room that you (patient or visitor) may touch. Wipe down doorknobs, nurse call buttons, tray tables, bed rails, light switches, faucet handles, etc.
• If a doctor prescribes antibiotics, ask if you need these medications, or if the doctor is prescribing them as a precaution. Doctors sometimes prescribe antibiotics out of an excess of caution or due to standard protocols that may not apply to you (or your loved one).

Is there any good news?

Fortunately, there are many organizations working on new products to either treat or prevent bacterial infections. Learn more in The Pew Charitable Trusts report.

Learn more…

To reduce your risk of infection, read these blog posts:

• Germs in Hospitals and Doctor Offices – Watch Out!
• How to Protect Yourself from Hospital Infections.
• Why is Sepsis so Dangerous?
• How do you Get C. Diff Infections?
• Handwashing in Healthcare Could Save Your Life!
• Tips for Hospital Discharges.
• What’s Your Hospital’s Safety Record? Is Your Hospital Safe?
• Is Your Hospital Safe? Are Programs in Place to Avoid Dangerous “Never Events”?