Four patients have died and nine others were infected as the 13 cases of a drug resistant strain of Candida auris that is emerging globally have been reported in the United States by the CDC.1
According to the CDC, seven of the cases occurred between May 2013 and August 2016. Six additional cases are still under investigation. Among the seven cases detailed in the report, patients with C. auris were reported in New York, Illinois, Maryland and New Jersey.
All of the patients had serious underlying medical conditions and the four deaths could not be attributed solely to C. auris infections. Transmission between patients in the same hospital or long-term care facility was strongly suggested by identical fungal strains in two incidents, the CDC reported.
“[W]hole-genome sequencing results demonstrate that isolates from patients admitted to the same hospital in New Jersey were nearly identical, as were isolates from patients admitted to the same Illinois hospital,” the CDC reported.
In addition, isolates from one patient were detected on environmental surfaces in the healthcare environment and some patients were persistently colonized. The CDC recommended hospitals put identified patients with C. auris in contact isolation precautions and room cleaning with an EPA-registered fungal disinfectant.
“In nursing homes, providers should consider the level of patient care being provided and the presence of transmission risk factors when deciding on the level of precautions,” the CDC stated. “If such patients are transferred to other healthcare facilities, receiving facilities should be notified of the presence of this multidrug-resistant organism to ensure appropriate precautions are continued.”
Most of the C. auris strains in the U.S. were drug-resistant, but didn’t have the multidrug characteristics of the international strains. This suggests that the strains were acquired locally rather than acquired via travel, the CDC noted.
First reported in 2009 in Japan, C. auris has now been identified in other parts of Asia, Africa, South America and the United Kingdom. The pathogen was previously detected in the U.S. in 2013, so there is concern that it will become recurrent given its emergence now and growing global presence.
- Centers for Disease Control and Prevention. Investigation of the First Seven Reported Cases of Candida auris, a Globally Emerging Invasive, Multidrug-Resistant Fungus — United States, May 2013–August 2016 MMWR Early Release / November 4, 2016: http://bit.ly/2fmiHvq