Candida auris, a highly resistant and dangerous fungal infection, has been identified across much of the United States, raising alarms within the medical community and prompting calls for heightened surveillance and control measures. Between 2016 and 2023, there have been 10,788 clinical cases recorded domestically, according to data from the Centers for Disease Control and Prevention (CDC).
This opportunistic fungus primarily affects individuals in healthcare settings, such as hospitals and nursing homes, especially among patients with invasive devices like breathing and feeding tubes. C. auris is capable of causing severe infections that are often resistant to multiple antifungal drugs, presenting significant challenges in treatment.
The CDC has declared C. auris an “urgent antimicrobial resistance threat” due to its ability to spread easily within healthcare facilities and its association with high mortality rates in those already seriously ill. The exact death toll from the infection is difficult to ascertain, as most patients affected by C. auris suffer from other concurrent severe health issues.
States like New York, Illinois, California, Florida, and Nevada have seen the highest incidences, each reporting over 1,000 cases. A second tier of states, including Texas, New Jersey, Indiana, Ohio, and several others, reported between 101 to 500 cases. Meanwhile, states such as Utah, New Mexico, and a dozen others reported the lowest numbers, ranging from one to 10 cases. Notably, Alaska, Idaho, Kansas, Maine, and several other states have not reported any cases.
Beyond those diagnosed through clinical assessment, an additional 22,931 individuals tested positive for colonization without symptoms. Colonization refers to the presence of C. auris on skin or other bodily sites without active infection. However, colonized individuals can still spread the fungus to surfaces and other people, highlighting the risk of broader transmission.
C. auris infections can occur in various parts of the body, including the bloodstream, wounds, and ears, and often manifest with symptoms commonly associated with bacterial infections, such as fever or chills. However, there is no definitive symptom uniquely indicative of C. auris, complicating diagnosis efforts.
When it comes to treatment, the medical community faces additional hurdles. Most strains of C. auris show resistance to at least one major class of antifungal medication, and some are resistant to all three main classes. While many infections can be managed with echinocandins—a class of antifungal medications—there are cases where these drugs prove ineffective. In such instances, healthcare providers may resort to combining multiple antifungal medications or utilizing newer, not yet approved drugs as a last resort.
The increasing prevalence of C. auris and its resistance to treatment underscore the urgency for healthcare facilities to implement stringent infection control practices. Enhanced surveillance, timely identification of cases, and diligent environmental cleaning are essential steps to contain its spread. Furthermore, ongoing research into effective treatments remains critical to combat this formidable healthcare threat.