Candida auris(C.auris) is a type of yeast that can cause severe illness and spread easily among healthcare patients. C.auris was first reported in Japan in 2009 and it is an emerging pathogen. It has been associated with nosocomial outbreaks mainly in the ICU setting. It is challenging to treat such infections as they’re often resistant to antifungal treatments. It has been associated with a mortality rate of 35 to 50%.
According to Dr Kartik Vedula, Consultant Infectious Diseases, Yashoda Hospitals Hyderabad, risk factors for infection include uncontrolled diabetes, CKD, and invasive medical devices like IVs, catheters, urinary catheters, and feeding tubes.
Candida auris can cause infection of the bloodstream, urinary tract, or open wounds. Symptoms depend on the site of infection but often fever may be the only symptom.
How to diagnose Candida auris?
Diagnosis is done by fungal culture of the appropriate clinical specimen. Candida auris is often resistant to commonly used Antifungals. Treatment depends on the antifungal susceptibility report. Most infections can be treated by a class of antifungals called echinocandins. Some stains have been reported to be pan-resistant, in such cases, we use multiple antifungals in combination for treatment. Patients who are colonised (Candida auris detected on their body but do not have symptoms of infection) should not be treated with antifungals as there is no evidence that this prevents illness.
Infection prevention and control
Candida auris infection is a concern because it is a multidrug-resistant yeast and is associated with significant mortality with the potential for outbreaks of infection. Some common disinfectants are less effective at eliminating it, and it can remain on a patient’s skin as a coloniser allowing spread to others. Therefore, it has significant healthcare implications and controlling the spread of this infection is vital.
Infected patients should be isolated to a single room, with the use of standard and contact precautions with regular hand hygiene. The patient should be given a daily chlorhexidine bath. Thorough daily and terminal disinfection of the environment must be done. Patient attendants must also use disposable gloves and maintain proper hand hygiene.
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