Candida auris, a multidrug-resistant fungus that is emerging globally, poses many infection control challenges, not the least of which is that it is difficult to identify with traditional diagnostics.
To address this issue, the CDC awarded investigators at Rutgers University a $300,000 grant to develop better testing methods.
“It is very difficult to detect with current methodologies that are used in hospitals, so it sort of flew in under the radar,” says David S. Perlin, PhD, executive director of the Public Health Research Institute at Rutgers. “The best and most accurate way is through a molecular test we published a few months ago on the development of a real-time PCR assay to rapidly identify this pathogen.”
That study1 described a test that targets rDNA region nucleotide sequences, which are specific identifiers for C. auris. “That set the foundation for the CDC grant,” he says. “We have been working with CDC on this issue for the better part of a year.”
If the test is validated in this larger trial, it will enable hospitals to rapidly identify C. auris in patients or the hospital environment.
“We can identify it from a surface in less than two hours using real-time PCR,” Perlin says. “What is really unique about C. auris is that it is the first yeast that we have seen that survives very nicely outside of the body.”
Candida species such as C. albicans on an immune-suppressed patient’s skin flora may seed an infection, but C. auris is transmitting between patients more like a bacterial pathogen.
“C. auris can persist on skin, on surfaces, and it can be transmitted in principle from patient to patient,” Perlin says. “That’s what makes it rather unique. In many ways it is like the Staph aureus of the yeast and Candida world. It is extremely unusual and also problematic. From an infection control standpoint it is very difficult to eradicate from hospitals.”
And given its high level of resistance to antifungal drugs, it poses an immediate risk to frail patient populations.
“This pathogen is life-threatening, with mortality rates somewhere between 40% and 60%,” he says. “So you really have to be able to identify it and manage it. It develops multidrug resistance, and in many cases it just becomes an untreatable strain.”
- Kordalewska M, Zhao Y, Lockhart, SR, et al. Rapid and Accurate Molecular Identification of the Emerging Multidrug-Resistant Pathogen Candida auris. J Clin Microbiol 2017;55:2445–2452.