Healthcare sector alerted to new fungal threat to patients

Institutions around the world are being warned of a fungal strain Candida auris that is resistant to normal treatment and is proving fatal in many cases

At the end of June, both the US Centers for Disease Control and Prevention (CDC) and Public Health England (PHE) alerted healthcare providers, including microbiologists and infection prevention and control personnel, to the emergence of Candida auris. In addition, guidance was published for the laboratory investigation, management and infection prevention and control of cases of this fungal pathogen.

The yeast species was first isolated from the external ear of a patient in Japan in 20091. Infections have typically occurred in hospitals where patients’ immune systems are weakened or they have been taking antimicrobials that have allowed opportunistic fungal infections to take hold. Infection leads to candidaemia – manifesting in flu-like symptoms, chronic fatigue, confusion and wound infection. Severe cases lead to septicaemia and death. Up to 60 % of infected patients have died, but this may be more of a consequence of complications due to pre-existing illnesses rather than from the yeast infection.

Healthcare facilities in several countries have reported that C. auris has been causing severe illness in hospitalised patients and at least two countries have reported outbreaks involving more than 30 patients. Published reports have described infections in the US, Japan, South Korea, India, South Africa and Kuwait. Infections also have occurred in Pakistan, Colombia, Venezuela, and the UK.

Because identification of C. auris requires specialised lab methods, infections are likely to have occurred in other countries but have not been identified or reported.

Measures are being put into place in some hospitals – where risk of infection is highest – to control the spread of the pathogenic yeast, but it is proving difficult to contain.

1. Satoh K, et al. Candida auris sp. nov., a novel ascomycetous yeast isolated from the external ear canal of an inpatient in a Japanese hospital. Microbiology and Immunology. 2009; 53(1): 41-4.

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