What Is Candida Auris?

First recognized in 2009, Candida auris is a yeast (a fungus) that can lead to candidiasis, a dangerous and potentially lethal disease. Candida auris symptoms may include fever, chills, and pain depending on what part of the body is affected.

This fungus becomes especially problematic when it enters the bloodstream and spreads throughout the body. Not only is this condition hard to detect, but it also leads to infections as it spreads.

What makes Candida auris alarming is that infections are most often detected within hospitals and clinical environments. Notably, more than 1,400 cases were reported within the U.S. from March 2021 to February 2022, with the most occurring in California, Floria, New York, and Illinois. While this is by no means a common infection, its rise in recent years is concerning.

This article discusses the symptoms, causes, diagnosis, and treatment of candida auris infection.

What Are the Symptoms of Candida Auris?

The symptoms of Candida auris infection—called candidiasis—depend on what part of the body is affected. Further complicating matters is the fact that since the disease most often arises in clinical environments and in patients who are already suffering from other conditions, signs can easily be missed.

Antifungal Resistance

A characteristic of Candida auris infection is that standard antifungal medications are sometimes completely ineffective or work poorly.

Antifungal resistance is an ongoing issue that can develop over time with the general use of antifungal medications. Plus, fungicides that kill and prevent fungus in agriculture may also contribute to resistance in those exposed to the fungicides. 

Ear Infection

An ear infection is characterized by either sharp or dull pain in the ear canal, a feeling of “fullness” in the ear, muffled hearing, ear drainage, and nausea.

Wound Infection

Characterized by bacterial invasion of tissues from a wound that is healing, this infection leads to inflammation, redness around the site of injury, discharge of yellowish or orange pus from the wound, increased tenderness around the wound, delayed healing, and fever.

Blood Infection

Probably the most dangerous outcome of Candida auris spread is an infection of the bloodstream. This potentially fatal condition is characterized by fever, chills, sweats, pain, and a general feeling of tiredness and malaise.

Urine samples have also been found with Candida auris, though it’s unclear how much of a risk there is of bladder infection.

What Are the Causes of Candida Auris?

Spores of this fungus can reside within clinical equipment and on surfaces in hospitals, becoming especially dangerous if they’re present in tubes and catheters used in medical procedures.

While it’s generally harmless if present on closed skin, problems arise if there’s a wound or contact with the bloodstream. Infections often occur in those who are hospitalized with other health conditions.

While the rise in cases over the last couple of years is alarming, it’s important to note that Candida auris infection is rare. Most healthy adults, for instance, are unlikely to contract candidiasis.

How Is Candida Auris Diagnosed?

Similar to bacterial infections, detection of Candida auris requires blood tests as well as those of other bodily fluids. While there are a number of these tests, the problem with detecting this pathogen is that it’s very similar to others of the same family and can be misdiagnosed; a quick diagnosis is rarely possible.

According to the CDC, a category of tests is likely the most effective: matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF). However, researchers and healthcare providers note that more accurate testing is needed.

How Is Candida Auris Treated?

The biggest obstacle when it comes to treating these fungal infections is that they can be very resistant to antifungal medication.

A class of antifungals called echinocandins can treat most infections and is recommended as the initial treatment. These include:

• Eraxis (anidulafungin)
• Cancidas (caspofungin)
• Mycamine (micafungin)

However, some Candida auris infections are resistant to all the main classes of antifungals, and multiple antifungals at high doses may be needed. A healthcare provider experienced in treating difficult fungal infections should be involved in this treatment plan, according to the CDC.

Because Candida auris can develop resistance quickly, patients receiving antifungal therapy should be monitored carefully with follow-up blood tests.

Why Is Candida Auris Dangerous?

Although Candida Auris was just discovered in 2009, it has spread quickly, especially in hospitals and nursing homes, in the U.S. and globally. What makes it so dangerous is that Candida Auris causes serious infections, is difficult to identify, and is resistant to antifungal medicines typically used to treat it.

Based on information from a limited number of patients, 30%–60% of people with Candida auris infections have died. However, many of these people had other serious illnesses that also increased their risk of death.

How to Prevent Candida Auris

The Centers for Disease Control and Prevention (CDC) is working with public health partners, healthcare personnel, and laboratories to prevent and stop the spread of Candida Auris in healthcare settings.

For prevention and control of Candida auris, the CDC recommends the following:

• Washing hands with alcohol-based hand sanitizer or soap and water regularly among family members of patients and healthcare personnel
• Cleaning and disinfecting the patient care environment and reusable equipment, including shared mobile equipment (such as glucometers and blood pressure cuffs)
• Maintaining separation of at least 3 feet between patient beds
  
• Screening contacts of newly identified patients to identify Candida auris colonization
• Laboratory surveillance to detect additional cases
• Communicating the patient’s Candida auris status when transferred to a different location

Summary

Not only is it important to keep an eye on hygiene, but you should also let your healthcare provider know if you suspect you have symptoms or if something seems off. Prognosis improves a great deal with earlier diagnosis. While there’s more to learn about this condition, it has caught the attention of public health officials and healthcare providers, which helps with prompt testing and early intervention and may lead to better treatments in the future.