The Centers for Disease Control and Prevention is calling an emerging fungus an “urgent threat” after a new study showed it’s been spreading at an “alarming rate” throughout health care facilities.
Cases of Candida auris (C. auris), which is resistant to several antifungal medications, has increased each year since it was first reported in 2016, with the most rapid rise occurring between 2020 and 2021, according to the study published Monday in the Annals of Internal Medicine.
- Cases detected through screening tripled from 2020 to 2021, totaling 4,041
- Cases that caused infection rose from 476 in 2019 to 1,471 in 2021
- 17 states identified their first case of C. auris ever between 2019 and 2021
“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,” said lead author Dr. Meghan Lyman, an epidemiologist at the CDC.
Researchers were equally concerned by the number of infections that were resistant to echinocandins, the antifungal medication recommended for treatment, which tripled compared to the previous two years.
Fungal infections can be life threatening to those most at risk in hospital settings, including patients who are very sick, have invasive medical devices, or have long or frequent stays in health care facilities, the agency said.
What is Candida auris, or C. auris?
Candida auris is a drug-resistant fungus that can cause outbreaks in health care facilities, according to the CDC.
The fungus can infect the bloodstream and even cause death by invading the blood, heart and brain, the agency said. More than 1 in 3 patients die from such an infection.
Experts say the pathogen is also dangerous because it’s often resistant to antifungal medicines commonly used to treat infections. It’s also difficult to identify without specialized laboratory technology and is often mistaken for other infections.
The agency said C. auris was first identified in 2009 in Asia and has quickly spread throughout the world. Since it began spreading in the U.S. in 2015, reported cases have increased more than 300%.
Candida auris infection symptoms
C. auris doesn’t always cause infection and can be carried on a patients’ skin, the CDC said, allowing easier spread to others.
But when it does cause infection, the agency said it may be difficult to identify as it most often impacts patients who are already sick with other diseases and exhibiting symptoms.
The CDC says fever and chills that don’t improve after giving antibiotics are the most common symptoms of C. auris.
Fighting fungal infections
Experts say fungal infections, including C. auris, also are difficult to treat because antifungals can be harmful to humans.
This makes prevention key, said Lance B. Price, professor of environmental and occupational health and the founder and co-director of the Antibiotic Resistance Action Center at George Washington University.
“The scary thing about candida auris and any of the drug-resistant fungal infections is just how difficult it is to find good, safe antifungals because people and fungi are built of the same stuff,” said Price, who is not affiliated with the CDC study.
Antifungal agents also are being overused in the agricultural setting, he added, which may contribute to more drug-resistant strains.
Study authors say the rise in C. auris cases may be due to increased surveillance efforts picking up more cases, decreased prevention efforts due to a burdened health care system during the COVID-19 pandemic, or both.
“Hospitals have to step up and screen patients for drug-resistant strains, isolate them, be on top of their game when it comes to infection control,” Price said.
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