Candida auris (C. auris) is a fungal infection, a type of yeast, and is often resistant to antifungal treatments. It is highly transmissible and can cause life-threatening illnesses. People who normally contract C. auris have a weakened immune system and normally are patients in the hospital or long-term care facilities. Immunocompromised patients or those with a medical device in their body (breathing tube, central venous line, etc.) are most likely to contract C. auris. Patients with a healthy immune system normally don’t experience symptoms but can transmit to others.
C. auris can cause invasive infections, and some patients can be colonized with C. auris without causing infections. Colonization refers to the presence and multiplication of microorganisms such as fungi, bacteria, or viruses. Patients that are colonized will not have symptoms and can spread the infection to other patients easily.
The CDC has issued an “urgent threat” warning as C. auris has been spreading rapidly, especially in New York state. In the US, there have been over 10,000 cases reported this year with at least 38 states confirming cases. Health experts are concerned because C. auris can resist antifungal drugs making treatment complex. The fungus has a mortality rate of up to 60%.
Some patients can become severely ill; others can have mild symptoms. The symptoms of C. auris could include:
Complications from C. auris include sepsis, shock, or organ failure.
The fungus spreads through contact with contaminated surfaces, objects in facilities, and person to person. It does not spread through the air. It can cause ear infections, wound infections, urinary tract infections, and infections in your blood. Infected and colonized patients can shed the fungus on objects including bedrails, doorknobs, and mobile medical equipment. If the surface is not disinfected properly, the fungus can live 7-14 days, depending on the environment’s temperature, humidity, and the type of surface.
C. auris can be difficult to diagnose. There is special testing, including lab testing with sequencing or mass spectrometry, that needs to be performed. Without special testing, it could be mistaken for other infectious diseases. Samples from the patient’s blood, urine, stool, fluid/tissue from a wound, or a swab of the groin, armpits, ears, vagina, or rectum need to be tested for the presence of the fungal infection. Treatment for C. auris is echinocandins, an antifungal medication, that usually cures the infection. However, some types of C. auris have become resistant to medications, making them harder to treat.
Infection control measures recommended for the prevention and control of spread of the infection should be strictly followed. These measures include, but are not limited to:
Hand hygiene is the single most critical measure for reducing transmitting organisms to patients and other healthcare personnel. C. auris has been found on the hands; therefore, adherence to good hand hygiene protocols must be followed. For hands that are not visibly soiled or dirty, alcohol-based hand sanitizer is preferred for cleaning hands. Always perform hand hygiene when entering and leaving a patient’s room.
PPE must be worn when caring for patients with C. auris. Follow donning and doffing techniques before entering and exiting a patient’s room. Dispose of PPE, gloves, and gowns carefully and perform hand hygiene.
Clean and disinfect the patient room and any other areas in the facility that came into contact with the patient. All chairs, patient beds, exam tables, blood pressure cuffs, and other equipment that were used in patient care must be thoroughly cleaned and disinfected appropriately. Disinfectants that are approved to be used must meet EPA-registered claims for C. auris. These disinfectants can be found in List P on the EPA’s website. Manufacturer’s instructions for use must be followed when utilizing the disinfectant, specifically, the contact time for disinfection must be met.
Another safety measure is to sterilize all medical devices that have been in contact with a patient with C. auris. Medical devices that can be reused must be cleaned, packaged/bagged, and disinfected or sterilized after each use. Sterilization provides the highest level of eliminating microbial life, including fungal spores, which are difficult to kill. Disinfection kills most microbes but does not necessarily eliminate all spores. Medical devices that are classified as critical are devices that enter the bloodstream or normally sterile tissue such as surgical forceps, implants, and catheters, and must be sterilized between each use. Semi-critical devices come into contact with mucous membranes or intact skin. Semi-critical items are ultrasound or vaginal probes. These items must be, at a minimum, high level disinfected or sterilized. Always follow manufacturer’s instructions on sterilization and disinfection of medical devices.
Following strict infection control measures can greatly reduce and prevent the spread of C. auris. The CDC has infection control guidance for healthcare settings. Healthcare facilities that suspect a patient with C. auris infection should contact state or local public health agencies for guidance.
Total Medical Compliance
6124 Creft Circle
Indian Trail, NC 28079
Phone: (888) 862-6742
Fax: (866) 875-3809
©2023 Total Medical Compliance
Total Medical Compliance
6124 Creft Circle
Indian Trail, NC 28079
(888) 862-6742
Fax (866) 875-3809
©2022 Total Medical Compliance
