Candida auris is a single-celled fungus that has emerged as a global health concern. First identified in Japan in 2009, this organism has rapidly spread worldwide. Its characteristics make it a threat in healthcare environments.
How Candida auris Spreads
Candida auris is not transmitted through the air like respiratory viruses. Its primary modes of transmission involve direct contact with infected or colonized patients and contact with contaminated surfaces or shared medical equipment. This fungus can reside on a patient’s skin without causing symptoms, a state known as colonization, allowing them to unknowingly shed the organism into their surroundings.
The organism persists on inanimate surfaces for extended periods, sometimes for weeks or even months. This persistence is attributed to its capacity to form biofilms, protective layers that help it survive despite cleaning efforts. Healthcare environments, particularly frequently touched surfaces like bedrails, doorknobs, and medical devices, can become reservoirs for the fungus. The transfer of the fungus from these contaminated surfaces to other patients or healthcare workers then facilitates its spread.
Why Candida auris is a Serious Concern
Candida auris poses a serious concern due to its multi-drug resistance. Many strains exhibit resistance to one or more main classes of antifungal drugs, including azoles, echinocandins, and polyenes, making infections difficult to treat effectively. Some isolates have even shown pan-drug resistance, meaning they are resistant to all available antifungal agents.
The fungus’s persistence on surfaces complicates infection control. It can survive on common healthcare materials and withstand routine disinfectants, potentially leading to ongoing transmission within facilities. Another challenge is its identification; standard laboratory methods can misidentify C. auris as other common Candida species. This misidentification can delay appropriate treatment and infection control measures, contributing to its spread.
Who is Most Susceptible to Candida auris
Individuals who are already ill or have weakened immune systems are most vulnerable to Candida auris infections. This includes patients in healthcare facilities, particularly long-term care settings and those requiring extensive medical care. Patients with invasive medical devices, such as breathing tubes, feeding tubes, central venous lines, or catheters, are also at increased risk. These devices can provide entry points for the fungus into the bloodstream and other body sites.
Underlying medical conditions, such as diabetes or blood cancers, can also increase susceptibility. Prolonged use of antibiotics or antifungals may disrupt the body’s natural protective flora, making individuals more prone to C. auris colonization and infection. Healthy individuals with intact immune systems face a low risk of developing severe C. auris infections.
Preventing the Spread of Candida auris
Controlling the spread of Candida auris, particularly in healthcare settings, involves rigorous infection prevention practices. Diligent hand hygiene is a primary defense, requiring healthcare providers to use alcohol-based hand sanitizer or wash hands with soap and water if visibly soiled. This practice helps prevent the transfer of the fungus from surfaces or patients.
Thorough environmental cleaning and disinfection are also essential, given the fungus’s ability to persist on surfaces. Healthcare facilities should use Environmental Protection Agency (EPA)-registered disinfectants effective against C. auris. This includes daily cleaning of patient rooms and equipment, as well as terminal cleaning upon patient discharge. Isolation precautions, such as placing infected or colonized patients in single rooms or cohorting them, help contain the organism. Surveillance measures are important for identifying new cases and outbreaks quickly, allowing for rapid implementation of control strategies.