C. auris: a Fungus that is Causing Growing Concern

Fungal infections are something we have lived with throughout history.

Athlete’s foot and ringworm are two common fungal infections that people deal with from time to time. Recently, however, a small but growing number of infections caused by a fungus known as Candida auris (C. auris) have led to rising concern for public health officials. 

For most healthy people, C. auris doesn’t seem to pose a threat. 

Problems seem to arise, says Lilian Abbo, M.D., a professor of Clinical Infectious Diseases at the University of Miami Miller School of Medicine and associate Chief Medical Officer for Infectious Diseases for Jackson Health System, for older patients who have underlying illnesses, are immunocompromised or use an invasive medical device such as a catheter or chest tube. Though rare, C. auris can get inside the body and cause dangerous infections and even death in some patients in these situations. 

According to the Centers for Disease Control and Prevention (CDC), the cases are occurring most frequently where these circumstances are present with large numbers of patients, such as in nursing homes or hospitals. Since C. auris was first reported in the U.S. in 2016, cases have grown to a total of 3,270 clinical cases (where an infection is present) and 7,413 screening cases (where the fungus is present but not causing infection). The CDC says that cases have almost tripled between 2019 and 2021. 

C. auris has a few unique characteristics that are leading to its spread. 

For one, she says, it’s a fungus that can survive high body temperatures and is very “sticky” on fomites and other environmental surfaces. These characteristics make it more challenging to eradicate and facilitate the spread in densely populated healthcare facilities with many at-risk patients. This bug is also resistant to first-line antifungal therapies, which makes it more difficult to treat. 

Several environmental factors have also coalesced recently to create a perfect storm for fueling the spread of C. auris. These include higher global temperatures, more people in hospitals and nursing homes due to the pandemic, the aging population, and burnout in healthcare personnel. Put it all together, and you can see why cases have started to rise. 

While all healthcare facilities have strict protocols for hand hygiene, equipment and environmental cleaning and disinfection, it’s possible that steps can be skipped or rushed when healthcare workers are busy or fatigued. The result can be a rising risk of infections such as C. auris. 

How C. auris Becomes Dangerous

When you pair the circumstances above with invasive medical devices such as catheters, tracheostomies, mechanical ventilation, and others, the risks of C. auris grow even greater. In those scenarios, it’s possible for C. auris to migrate from the skin or other surfaces into the blood, urine, wounds or other organs of the body.

Though it’s rare, that’s when a minor health risk can become a very serious, even deadly, situation for some patients. 

Protection from C. auris 

Now that public health officials and the public are becoming more aware of the risk of C. auris, the good news is that public health officials from the national to local levels are taking steps to reduce the risk.

In the state of Florida, for example, the Florida Department of Health has information and guidelines available for preventing the spread of C. auris. Dr. Abbo says that local hospital associations, laboratories, and infectious disease experts are also working diligently to create awareness, education, and preventive measures to protect patients from this risk.  

“One way we are protecting people is with increased screening to identify, isolate and treat individuals with colonization and preventing infections,” says Dr. Abbo.

“Of course, compulsive hand hygiene for healthcare personnel and cleaning of environmental surfaces and equipment are also key steps in preventing the spread.” 

You can also take steps to protect yourself and your loved ones. 

The same hygiene rules that apply in hospitals can be used in your home. Dr. Abbo recommends boosting your immune system as much as possible with practices like eating nutritious food, exercising, getting enough sleep and more.

Protecting patients who have chronic devices, reside in nursing homes, or have immunosuppression with the strategies mentioned before is key. Maintaining a healthy and diverse microbiome, a strong immune system and preventing infections are the first steps. 

Wyatt Myers is a regular contributor for UHealth’s news service.

Tags: antifungal medications, Dr. Lillian Abbo, type of fungal infection, weakened immune system