Threat From Deadly Fungal Infection Increases in Healthcare Facilities

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Candida auris (C. auris), a new fungus regarded as an urgent antimicrobial resistance (AR) threat, spread at an alarming rate in U.S. healthcare facilities in 2020-2021, according to data published in the Annals of Internal Medicine by the Centers for Disease Control and Prevention (CDC).

Concerningly, the number of C. auris infections resistant to echinocandins, the antifungal drug most commonly suggested for treatment, tripled in 2021. C. auris poses no hazard to healthy individuals. C. auris is more likely to infect individuals who are severely ill, have invasive medical devices, or have lengthy or frequent stays in healthcare settings. C. auris is frequently resistant to numerous antifungal medicines, spreads easily in healthcare institutions, and can cause severe infections with high mortality rates, according to the CDC.  

“The rapid increase and geographic spread of infections are troubling and highlights the need for continuing surveillance, expanded lab capacity, faster diagnostic tests, and adherence to proven infection prevention and control,” said CDC epidemiologist Dr. Meghan Lyman, the paper’s lead author.  

According to the article, C. auris has expanded in the United States since it was first diagnosed in 2016, with a total of 3,270 clinical cases and 7,413 screening cases recorded through December 31, 2021. Since 2016, the number of clinical cases has grown annually, with the rate of increase accelerating between 2020 and 2021.

For 2022, the CDC continues to observe an increase in case counts. 17 states reported their first C. auris case ever during 2019-2021. Clinical cases increased from 476 in 2019 to 1,471 in 2021 nationwide. From 2020 to 2021, the number of screening cases increased, reaching 4,041. Screening is necessary to prevent the spread of the fungus by identifying patients who are infected so that infection control measures can be implemented.  

Cases of C. auris have grown to numerous causes, including inadequate infection prevention and control (IPC) in healthcare facilities. Enhanced attempts to detect instances, such as expanded colonization screening, a test to determine if a person has the fungus but does not have an infection or symptoms of infection, may also have contributed to the rise in case counts.

The timing of this increase and the results of public health investigations suggest that the COVID-19 pandemic may have exacerbated the spread of C. auris throughout the healthcare and public health systems.  

A portion of the data for this study came from the CDC’s Antibiotic Resistance Laboratory Network, which provides nationwide lab capacity to promptly detect antimicrobial resistance and informs local responses to prevent its spread and protect people.

Using supplementary money provided by the American Recovery and Reinvestment Act, the CDC works to dramatically enhance laboratory capacity, including in state, territory, and municipal health departments. Among these efforts is the expansion of C. auris susceptibility testing capability from seven Regional Laboratories to more than 26 Laboratories nationally. 


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