An Overview of Candida Auris

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First recognized in 2009, Candida auris is a yeast-like fungus that can lead to candidiasis, a dangerous and potentially lethal disease. Most often arising in those with already weakened immune systems, 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, 600 cases have been reported within the U.S. facilities, with most occurring in New Jersey, New York, and Illinois. While this is by no means a common infection, its rise in recent years is alarming.

Symptoms

The tricky thing about Candida auris infection—called candidiasis—is that symptoms depend on what part of the body is affected. Further complicating matters is 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. Still, doctors have been able to nail down some markers that could be the result of candidiasis:

Antifungal Resistance

A characteristic of Candida auris infection is that standard antifungal medications will be completely ineffective or work poorly. This may be due to the use of such substances in agriculture.  

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. If untreated, this kind of infection can lead to permanent hearing loss.

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 infection of the bloodstream. This potentially fatal condition is characterized by fever, chills, pain, redness and swelling, fluid drainage (if there’s a site of incision), 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.

Untreated cases of Candida auris infection can lead to coma, and more than one-third of cases—especially if there’s bloodstream infection—lead to death.

Causes

Primarily, Candida auris infection is caused by exposure to the fungus itself. The problem is that 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. As noted, infections usually only occur in immunocompromised patients—oftentimes those with other health conditions—and may be more in common in those that take a lot of antibiotics.

While the rise in cases over the last couple years is alarming, it’s important to note that Candida auris infection is very, very rare. Most healthy adults, for instance, are unlikely to contract candidiasis; however, those who are hospitalized or are suffering from other health conditions, as well as very young people, are certainly at risk.

Diagnosis

Like other kinds of 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 Centers for Disease Control (CDC), a category of tests is likely the most effective: matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF). However, researchers and doctors note that more accurate testing is needed.

Treatment

The biggest obstacle when it comes to treating infections of this bacteria is that it can be very resistant to antifungal medication. Preventative approaches such as ensuring hands are kept clean and medical equipment and surfaces are hygienic are surely the best bet to prevent spread.

Drugs that may be effective include Anidulafungin, Caspofungin, and Micafungin. since colonies of Candida auris can persist despite treatment with these, constant infection control measures may be necessary.

A Word From Verywell

Not only is it important to keep an eye on hygiene, you have to let your doctor know if you suspect you have symptoms or 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 doctors, which will undoubtedly lead to fewer cases and stronger treatments.

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Article Sources

  1. Jeffery-Smith A, Taori S, Schelenz S et al. Candida auris: a Review of the Literature. Clin Microbiol Rev. 2017;31(1). doi:10.1128/cmr.00029-17


  2. Centers of Disease Control. Identification of Candida auris: Candida auris: Fungal Diseases. Cdc.gov. https://www.cdc.gov/fungal/candida-auris/recommendations.html. Published 2019. 

Additional Reading

  • Shmerling R. The latest deadly superbug — and why it’s not time to panic - Harvard Health Blog. Harvard Health Blog. https://www.health.harvard.edu/blog/candida-auris-the-latest-deadly-superbug-and-why-its-not-time-to-panic-2019050816606.