On Monday, the CDC announced that cases of the drug-resistant fungus Candida auris are increasing at an “alarming” rate in U.S. hospitals.
In 2016, only a small number of individuals with Candida auris were reported to the CDC each year for several years after the first American cases were identified. However, recent CDC data published in the Annals of Internal Medicine indicates that the rate of cases has increased.
Thirty states plus the District of Columbia reported Candida auris cases as of 2021, a 95% increase from 756 in 2020. Preliminary figures indicate that 2,377 cases may be reported for 2022. According to CDC epidemiologist Dr. Meghan Lyman, “We’re continuing to see the number of cases increase. So what we saw before is continuing. It didn’t stop. The issues that we’ve seen are continuing, and it didn’t resolve.”
Candida auris is a type of yeast that frequently has no symptoms in healthy individuals. Yet, the fungus poses a significant concern to individuals already weak from other conditions since it spreads throughout the body’s systems and causes severe and invasive complications.
Almost all Candida auris test samples have shown resistance to at least one type of antifungal medication.
Lyman stated that it could be challenging to determine the precise role the fungus played in some of these vulnerable patients, adding that one in three patients with invasive infections passes away.
Some patients, even those who recover from invasive infections, may continue to be “colonized” with Candida auris for years after their treatment.
“There’s still a lot to learn about colonization patterns. But the treatment doesn’t seem to completely— while it may treat the infection, we don’t have evidence that it eliminates C. auris from their body,” said Lyman.
The fungus was already ranked as the most “urgent” threat among emerging drug-resistant infections in a 2019 CDC report. The CDC added Candida auris to the list of drug-resistant diseases that have risen alarmingly in the years following COVID-19.
Lyman highlighted studies that found some connections, even though it is difficult to determine the precise influence of the pandemic on this trend.
Given the risk it poses to vulnerable patients and the challenges doctors encounter in treating and preventing drug-resistant infections, the World Health Organization classified Candida auris as one of the most significant fungal risks to public health today.
Echinocandin, the initial drug advised for treating patients experiencing Candida auris infections, was only resistant to less than 5% of tested cases.
According to Lyman’s analysis, “pan-resistant” fungal infections, or those resistant to all treatments, have also increased.
In Texas and Washington, D.C., outbreaks were reported by health authorities in 2021, suggesting that resistant infections are spreading even among individuals who have never received echinocandin treatment.
According to Lyman, hospitals and nursing homes can stop the spread of Candida auris by screening for cases and taking specific precautions to isolate affected patients.
“There’s a lot of attention on the big outbreaks and widespread transmission, but something that doesn’t get as much attention is the facilities or areas that can prevent transmission,” Lyman said.
Over the last few years, labs can now detect and diagnose cases.
“For some of these places, not ever seeing a case again may not be realistic. But there’s still a lot that can be done to prevent the spread,” she said.
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