- Health officials are expressing concerns over the recent increase in cases of a fungal infection known as Candida auris.
- They say there is particular concern because C. auris is becoming resistant to a number of drugs.
- They stress that the threat to the general public is still low, but they note the infection could spread quickly in healthcare facilities such as nursing homes.
It won’t take over your brain like the fungus in the HBO series The Last of Us.
However, cases of a highly contagious and sometimes fatal fungal infection have risen in recent years.
Researchers from the U.S. Centers for Disease Control and Prevention (CDC) report that cases of Candida auris have risen by double digits each year between 2019 and 2021, blooming from a 44% spike in 2019 to a 95% year-over-year increase in 2021.
Dr. Susan Huang, the medical director of epidemiology and infection prevention at UCI Health, a program at the University of California Irvine, told Healthline that C. auris is “uncontrolled and spreading.”
“As a contagious fungus, it has the potential to have broad and grave effects over time, particularly in those who require a lot of healthcare support and frequently take antibiotics,” she said.
C. auris cases only began showing up in the United States in 2016, but the fungus has already been labeled an “urgent threat” by the CDC.
C. auris can spread easily in healthcare facilities, particularly among residents of long-term care facilities and those on ventilators or with “indwelling” devices such as catheters and feeding tubes.
“It has emerged in multiple countries around the world, suggesting a propensity for global impact and spread,” said Huang. “This fungus behaves in an unusual fashion – it’s contagiousness is similar to another major antibiotic-resistant pathogen, methicillin-resistant Staphylococcus aureus, or MRSA. It spreads easily from the nose and skin to nearby objects and can spread by touching someone who has it or touching something that is contaminated.”
The study authors suggested that the spread of C. auris may mean that it is linked to the COVID-19 pandemic-related strain on the healthcare and public health systems such as staff and equipment shortages, increased patient burden and disease severity, increased antimicrobial use, changes in patient movement patterns, and poor implementation of non–COVID-19 infection-control measures.
“The risk to the general population remains very low,” Lipps noted.
However, Huang added, “the concern is that the spread in healthcare will form a gateway to broader community settings, such as those with complex medical conditions who are recovering at home or need frequent outpatient clinical care.”
“The increasing prevalence of C. auris among hospitalized patients highlights the urgent need for enhanced infection control practices and vigilant surveillance,” Dr. Alpana Mohta, a dual board-certified dermatologist, told Healthline. “Healthcare providers must exercise appropriate caution and follow strict infection control protocols to prevent transmission of the organism in healthcare facilities.”
“Antibiotic stewardship programs have been shown to reduce the incidence of healthcare-associated infections and improve patient outcomes,” added Mohta. “By limiting the use of antibiotics, healthcare providers can help prevent the emergence and spread of drug-resistant organisms such as C. auris.”
Symptoms of the Candida auris vary, but they can include fever and chills. Experts do note that these symptoms are also common with other types of infection.
The increase is particularly concerning because the C. auris fungus is frequently resistant to commonly used antifungal medications such as fluconazole.
CDC researchers reported today in the journal Annals of Internal Medicine that the number of C. auris cases that were resistant to first-line treatment in 2021 increased threefold over 2019 and 2020.
“If someone has an infection with C. auris, the fungus will need to be sent to the lab for susceptibility testing to determine which antifungal medication will work best to treat it,” explained Dr. Ashley Lipps, an infectious diseases physician at The Ohio State University Wexner Medical Center.
“Fortunately, most cases of C. auris in the United States remain susceptible to a class of antifungal medications known as echinocandins,” she told Healthline.
Candida diseases include common “yeast infections” that typically do not spread from person to person. However, “this particular candida species is behaving differently.”
“It colonizes the body, can spread to others through contact, and finds opportunities to cause severe disease, such as in the bloodstream or in wounds,” said Huang.
But while C. auris is a serious problem, it’s not an apocalyptic one.
“The Last of Us focuses on an insect-infecting fungus and morphs it into an apocalyptic pathogen that taints the human food supply and ultimately can spread from human-to-human through bite wounds and through the air from end-stage infected humans,” said Huang. “Fortunately, this confluence of catastrophic events is extremely unlikely.”