Print Friendly, PDF & Email

RSTV: IN DEPTH- THE DEADLY FUNGUS- CANDIDA AURIS

RSTV

Introduction:

The fungus is emerging as a global threat, having spread in at least 15 countries and claimed several hundred lives. Identified in 2009 in Japan, the deadly fungus is infecting patients in hospitals and nursing homes around the world. According to the Centers for Disease Control and Prevention, nearly half of the patients who contract Candida Auris die within 90 days. Yet, scientists haven’t been able to nail down where the fungus came from in the first place.

Candida auris:

  • Although C. auris was first identified in 2009 in Japan, it has spread quickly and caused infections in more than a dozen countries.
  • Candida is a genus of fungi (yeasts) that live on the skin and inside the human body. Candida auris (also called auris) is an uncommon fungus that can cause serious infections.
  • Most people who carry the fungus on their body do not get sick from it, but sometimes it can lead to serious bloodstream, wound and ear infections. People who carry the fungus (known as colonisation) are considered to be colonised for life.
  • Infections caused by auris are concerning because they can be more difficult to treat than other candida infections, as they are often resistant to medicines.
  • Candida auris can also spread more easily from person to person than other types of Candida. For this reason, auris can cause problems in hospitals and nursing homes as it can spread from one patient to another or via shared objects.
  1. auris is more likely to affect patients who have:
  • a hospital stay in an area with documented or suspected C. auris transmission
  • a prolonged hospital stay
  • an indwelling medical device, such as a central venous catheter, urinary catheter, biliary catheter or wound drain
  • an impaired immune system
  • multiple or recent exposures to broad spectrum antibiotics
  • diabetes mellitus
  • had recent surgery.

What will happen if one has Candida auris?

  • Patient will be moved to a single room and a sign will be placed on your door to remind health care workers who enter your room about the special precautions they need to take, such as wearing a gown and gloves.
  • Everyone, will need to wash their hands or use an alcohol-based hand rub before entering or leaving your room.
  • An alert will be placed in your hospital record to alert staff, if you are admitted another time, that extra precautions are required.

Concerns:

  • It is often multidrug-resistant, meaning that it is resistant to multiple antifungal drugs commonly used to treat Candida
  • It is difficult to identify with standard laboratory methods, and it can be misidentified in labs without specific technology. Misidentification may lead to inappropriate management.
  • It has caused outbreaks in healthcare settings. For this reason, it is important to quickly identify auris in a hospitalized patient so that healthcare facilities can take special precautions to stop its spread.

Prevent the spread:

  • avoid touching any areas of broken skin or wound dressings
  • ensure you wash your hands or use an alcohol-based hand rub, particularly
    • after using the toilet
    • before eating food
    • whenever you leave your hospital room.

Visitors should also continue to practice good hand hygiene and ensure they wash their hands or use alcohol-based hand rub before and after touching patients or any items around the bedside.

Is C. auris treatable:

  • Most C. auris infections are treatable with antifungal drugs. However, some C. auris infections have been resistant to all three main classes of antifungal medications, making them more difficult to treat

Why is multidrug resistance a problem?

  • The increase in resistant organisms is fueled by overuse of antimicrobial drugs, not just in healthcare settings but also in agriculture.
  • As more microorganisms evolve ways to survive commonly used drugs, treating infections becomes more difficult. This increases the risks associated with hospitalizations and surgeries.