Candida auris infection

Definition

Candida auris (C auris) is a type of yeast (fungus). It can cause a severe infection in hospital or nursing home patients. These patients are often already very sick.

C auris infections often do not get better with the antifungal medicines that usually treat candida infections. When this occurs, the fungus is said to be resistant to antifungal medicines. This makes it very hard to treat the infection.

C auris infection is rare in healthy people.

Alternative Names

Candida auris; Candida; C auris; Fungal - auris; Fungus - auris

Causes

Some patients people carry C auris on their bodies without it making them sick. This is called "colonization." This means they can easily spread the germ without knowing it. However, people who are colonized with C auris are still at risk for getting an infection from the fungus.

C auris can be spread from person-to-person or from contact with objects or equipment. Hospital or long-term nursing home patients can be colonized with C auris. They can spread it to objects in the facility, such as bedside tables and hand rails. Health care providers and visiting family and friends who have contact with a patient with C auris can spread it to other patients.

Once C auris enters the body, it can cause a severe infection of the bloodstream and organs. This is more likely to occur in people with a weakened immune system. People who have breathing or feeding tubes or IV catheters are at the highest risk of infection.

Other risk factors for C auris infection include:

• Living in a nursing home or making many visits to the hospital
• Taking antibiotic or antifungal medicines often
• Having many medical problems
• Having had a recent surgery

C auris infections have occurred in people of all ages.

Symptoms

C auris infections can be hard to identity for the following reasons:

• Symptoms of a C auris infection are similar to those caused by other fungal infections.
• Patients who have a C auris infection are often already very sick. Symptoms of infection are hard to tell apart from other symptoms.
• C auris can be mistaken for other types of fungus unless special lab tests are used to identify it.

High fever with chills that does not get better after taking antibiotics may be a sign of a C auris infection. Tell your provider right away if you or a loved one has an infection that is not getting better, even after treatment.

Exams and Tests

A C auris infection can't be diagnosed using standard methods. If your provider thinks your illness is caused by C auris, they will need to use special lab tests.

Blood tests include:

• CBC with differential
• Blood cultures
• Basic metabolic panel
• B-1,3 glucan test (testing for a specific sugar found on some fungi)

Your provider also may suggest testing if they suspect you have been colonized with C auris, or if you have tested positive for C auris before.

Treatment

C auris infections are often treated with antifungal medicines called echinocandins. Other types of antifungal medicines also may be used.

Some C auris infections do not respond to any of the main classes of antifungal medicines. In such cases, more than one antifungal drug or higher doses of these drugs may be used.

Outlook (Prognosis)

Infections with C auris can be hard to treat because of its resistance to antifungal medicines. How well a person does will depend on:

• How severe the infection is
• Whether the infection has spread to the bloodstream and organs
• The person's overall health

Possible Complications

C auris infections that spread to the bloodstream and organs in very ill people can often lead to death.

When to Contact a Medical Professional

Contact your provider if:

• You have fever and chills that don't improve, even after antibiotic treatment
• You have a fungal infection that doesn't improve, even after antifungal treatment
• You develop fever and chills soon after coming in contact with a person who has a C auris infection

Prevention

Follow these steps to prevent the spread of C auris:

• Wash your hands thoroughly with soap and water. Or, use an alcohol-based hand sanitizer. Do this before and after contact with people who have this infection and before and after touching any equipment in their room.
• Make sure health care providers wash their hands or use hand sanitizer and wear gloves and gowns when interacting with patients. Don't be afraid to speak up if you notice any lapses in good hygiene.
• If a loved one has a C auris infection, they should be isolated from other patients and kept in a separate room.
• If you are visiting your loved one who has been isolated from other patients, please follow the directions of the healthcare workers on the procedure to enter and exit the room to minimize the chance of spreading the fungus.
• These precautions should also be used for people who are colonized with C auris until their provider determines they can no longer spread the fungus.

Contact your provider right away if you suspect that you or someone you know has this infection.

References

Centers for Disease Control and Prevention website. Candida auris. www.cdc.gov/fungal/candida-auris/index.html. Updated April 30, 2019. Accessed May 6, 2019.

Centers for Disease Control and Prevention website. Candida auris: A drug-resistant germ that spreads in healthcare facilities. www.cdc.gov/fungal/candida-auris/c-auris-drug-resistant.html. Updated: December 21, 2018. Accessed May 6, 2019.

Centers for Disease Control and Prevention website. Candida auris colonization. www.cdc.gov/fungal/candida-auris/fact-sheets/c-auris-colonization.html. Updated: December 21, 2018. Accessed May 6, 2019.

Centers for Disease Control and Prevention website. Candida auris information for patients and family members. www.cdc.gov/fungal/candida-auris/patients-qa.html. Updated: December 21, 2018. Accessed May 6, 2019.

Centers for Disease Control and Prevention website. Infection prevention and control for Candida auris. www.cdc.gov/fungal/candida-auris/c-auris-infection-control.html. Updated: December 21, 2018. Accessed May 6, 2019.

Centers for Disease Control and Prevention website. Treatment and management of infections and colonization. www.cdc.gov/fungal/candida-auris/c-auris-treatment.html. Updated: December 21, 2018. Accessed May 6, 2019.

Cortegiani A, Misseri G, Fasciana T, Giammanco A, Giarratano A, Chowdhary A. Epidemiology, clinical characteristics, resistance, and treatment of infections by Candida auris. J Intensive Care. 2018;6:69. PMID: 30397481 www.ncbi.nlm.nih.gov/pubmed/30397481.

Jeffery-Smith A, Taori SK, Schelenz S, et al. Candida auris: a review of the literature. Clin Microbiol Rev. 2017;31(1). PMID: 29142078 www.ncbi.nlm.nih.gov/pubmed/29142078.

Sears D, Schwartz BS. Candida auris: an emerging multidrug-resistant pathogen. Int J Infect Dis. 2017;63:95-98. PMID: 28888662 www.ncbi.nlm.nih.gov/pubmed/28888662.