More infection protection is needed in health care facilities, the CDC says, where the dangerous fungus can spread and infect people who are already sick.
A drug-resistant fungus found in medical facilities spread at an "alarming rate" from 2020 to 2021, the US Centers for Disease Control and Prevention said on Monday. While the fungus, Candida auris, is generally not a threat to healthy people, the CDC said, it is a deadly threat to people who are very sick and those who have long stays in the hospital.
Importantly, the CDC noted, infections caused by C. auris are often resistant to many antifungal drugs and it can spread in health care settings, like hospitals or nursing homes. Antifungal drugs work against illnesses caused by fungi, similar to how antibiotics work against bacterial infections. Resistance to either is called antimicrobial resistance and is a growing threat to public health.
From 2019 to 2021, 17 states reported their first cases of C. auris, and the number of cases that didn't respond to the most common medication for it tripled within the two previous years, according to a paper the CDC published in the Annals of Internal Medicine.
"The rapid rise and geographic spread of cases is concerning and emphasizes the need for continued surveillance, expanded lab capacity, quicker diagnostic tests, and adherence to proven infection prevention and control," CDC epidemiologist Dr. Meghan Lyman, lead author of the paper, said in Monday's news release.
Here's what we know.
C. auris was first identified in 2009, but a deeper analysis found that it actually dates back to 1996. It was first reported in the US in 2016 and it's considered an "emerging pathogen" by the CDC because of its growth in countries outside of where it was first identified.
C. auris is a type of fungus or yeast that, in some patients, can enter the bloodstream and spread, causing very serious or fatal infections. It spreads in health care settings, including hospitals and nursing homes, and can cause outbreaks through direct contact, or by touching contaminated surfaces, according to the Virginia Department of Health.
More dangerous infections that infect the bloodstream typically occur in patients who have many medical problems, according to the CDC, and more than one in three patients diagnosed with C. auris will die within a month.
Because the patients who get sick with C. auris tend to already be ill for another reason, symptoms may not always be noticeable and can depend on the part of the body that's infected, according to the CDC. Lab tests are needed to diagnose an infection with C. auris, which is why the CDC is calling for awareness among health care workers.
C. auris is mostly a threat to people who have had long hospital stays, have a weakened immune system, have been treated with invasive medical devices (feeding tubes, for example), or have multiple medical problems, the CDC says. People without these conditions or circumstances don't get this type of infection, according to the CDC.
The rate that it's spreading and the fact that cases may be resistant to the drugs typically used to treat C. auris make it an urgent threat, according to the CDC.
The agency said that case counts likely increased because of "poor general infection prevention" in health care facilities, but that increased efforts to detect cases also may have contributed. The health care strain brought on the pandemic also had a hand in the stark rise in cases from 2020 to 2021, the CDC said.
"The timing of this increase and findings from public health investigations suggest C. auris spread may have worsened due to strain on health care and public health systems during the COVID-19 pandemic," the health agency wrote in its news release.