Candida auris: All you need to know about the deadly fungus spreading across the U.S

An emerging fungus called Candida auris is spreading rapidly and geographically, according to a warning from the US Centers for Disease Control and Prevention (CDC). More than half of the states in the country have now reported cases, and the pandemic has significantly contributed to the rise in infections. Candida auris is considered an urgent antimicrobial resistance (AR) threat, as it can cause severe infections with high death rates and is often resistant to multiple antifungal drugs, making it difficult to treat. From 2020 to 2021, the fungus spread rapidly in US healthcare facilities, as per CDC data.

According to The American College of Physicians, there has been a significant increase in cases of Candida auris, a lethal antibiotic-resistant fungal infection that was previously estimated to have a fatality rate of 60%. Yeasts and molds are evolving to avoid medications used to manage them, and this is contributing to the spread of the disease. While it is not as alarming as the zombie fungus portrayed in the popular TV show The Last of Us on Sky Atlantic, Candida auris is impervious to the only three available treatments. Fungal infections are a cause of millions of deaths globally each year.

This alarming trend highlights the need for ongoing surveillance, expanded lab capacity, quicker diagnostic tests, and strict adherence to proven infection prevention and control measures. The earliest known infections date back to 2013, and Candida auris was first described in Japan in 2009. Since then, it has become a severe global health threat.


Candida auris is a type of yeast that typically does not pose a threat to individuals in good health. However, it can prove to be a fatal danger for patients in hospitals and nursing homes who are in a fragile state. It has the potential to spread rapidly and can contaminate wounds, ears, and the bloodstream. Some strains of Candida auris are categorized as superbugs since they are resistant to all three classes of antifungal medication used to treat such infections.

How is it contracted?

Candida auris is primarily contracted in healthcare settings such as hospitals and nursing homes, where it is generally thought to be spread through contact with contaminated surfaces or by person-to-person transmission. The fungus can either colonize a specific region of the body, such as the skin, rectum, or mouth, without causing symptoms or it can cause severe invasive infections by entering the bloodstream or wounds.

According to a recent study, the number of cases of the infection has escalated significantly, with 476 cases reported in 2019, 756 cases in 2020, and 1,471 cases in 2021. Furthermore, medical professionals have discovered the fungus on the skin of numerous patients, thereby increasing the likelihood of transmission to others. Although a substantial number of initial cases in the US were attributed to imported infections, presently, the majority of infections are being transmitted domestically within the country, as the authors of the study have pointed out.

Symptoms

Diagnosing Candida auris can be difficult, as its symptoms are often similar to those of other common diseases, such as fever and chills that do not go away after treatment with antibiotics. Misdiagnosis often leads to the wrong treatment, and a correct diagnosis typically requires sending a blood sample or sample from an infection site to a specialized lab to definitively confirm the fungus is present.

Challenges

One of the key challenges with Candida auris is its ability to persist on surfaces, making it difficult to eradicate from healthcare settings. It can also survive in a range of environmental conditions, including high temperatures and high salt concentrations, which may contribute to its ability to colonize and infect patients.

Treatment

The spread of Candida auris is of significant concern to public health officials due to its resistance to multiple classes of antifungal drugs. This makes treatment challenging and often requires the use of combination therapies, which can be expensive and have significant side effects.

The mortality rate of Candida auris is estimated to be between 30-60%, based on information from a limited number of patients. However, many of the victims also had other serious illnesses that may have increased the risk of death. Antifungal drugs called echinocandins are used to treat this infection; however, there has been a rise in cases of resistance to the antifungals. This has meant physicians have had to mix multiple types of drugs at high doses to treat patients, with varying success.

Who are at risk?

People who are already suffering from other medical conditions, recent hospital stays, and invasive devices are most at risk of contracting the fungus. According to medical professionals, several factors can increase an individual's susceptibility to Candida auris, including recent surgical procedures, underlying medical conditions such as diabetes, and the extensive use of antibiotics and antifungal medications. Additionally, experts warn that people of all ages are at risk of contracting this infection.

While some have compared the spread of Candida auris to the plot of The Last of Us, where a fungus called cordyceps infects humans, there is no evidence that cordyceps can infect people.

What should be done

The emergence and spread of Candida auris highlight the need for better infection control measures in healthcare settings, as well as the development of new antifungal drugs. It also emphasizes the importance of accurate and timely diagnosis, as misdiagnosis can lead to inappropriate treatment and the spread of the fungus.

Discovery

Candida auris is a fungus that was first identified in Japan in 2009. It is a multi-drug resistant pathogen that is capable of causing invasive infections in the human body. Since its discovery, it has rapidly spread across the world, causing outbreaks in healthcare facilities and in the community. The fungus has been reported in more than 40 countries, including the United States, United Kingdom, South Africa, and Australia.

Efforts are underway to improve our understanding of Candida auris and to develop new treatments and strategies to control its spread. However, the emergence of this pathogen serves as a reminder of the ongoing threat posed by antimicrobial resistance and the urgent need for continued research and development of new drugs and diagnostics to address this global challenge.

In conclusion, Candida auris is a multidrug-resistant yeast that can cause serious and sometimes fatal infections. It is an emerging global health threat that has been reported in many countries. Candida auris infections are difficult to diagnose and treat because they are often resistant to multiple antifungal drugs. Although it is named after the Latin word for "ear," Candida auris can affect many parts of the body and can cause invasive infections, such as bloodstream, wound, and ear infections. Some strains of Candida auris have been found to be resistant to all three major classes of antifungal drugs, making treatment even more challenging. It is important to take precautions in healthcare settings to prevent the spread of Candida auris infections.