C. Auris: A Deadly New Superbug?>

C. Auris: A Deadly New Superbug

by Jennifer Doehner  

Superbugs get their name from their ability to resist antimicrobial drugs that are designed to destroy them. But, while they may not be able to leap tall buildings in a single bound, superbugs can do plenty ofdamage to mere mortals.

The most recent superbug emerging as a threat is known as Candida auris, or C. auris for short. The CDC considers it to be a major health threat because it resists most of the drugs aimed at treating the infections it causes, is able to spread from person to person, and is difficult to remove from health care environments.

Here are some things you should know.

What is Candida auris?

C. auris is a fungus that can cause potentially deadly infections if it enters the bloodstream. It gets its name auris from the Latin “ear” because it was first identified as a rare cause of an ear infection in apatient in Japan in 2009. However, researchers have since found that it first appeared in South Korea in 1996. It has now spread to more than 30 countries. The first reported case in the United States wasin 2015. C. auris can also cause other severe, invasive infections, including those associated with the brain, the heart, and surgical wounds.

What are the symptoms?

The most common symptoms are fever and chills, but symptoms can vary from person to person. It can be difficult for doctors to recognize a C. auris infection because patients are often already very sick from other ailments. Doctors usually suspect a superbug like C. auris when antifungal drugs don’t alleviate the signs and symptoms. To diagnose the disease caused by C. auris, clinicians obtain cultures from the patient’s blood, urine, and other sites.

The samples must be examined in a lab that has specialized technology with the ability to identify the bug, something not all medical centers have. It takes a few days to about a week to get the test results.

Who's most at risk?

The most vulnerable people are patients or residents of health care facilities such as hospitals, nursing homes, and assisted-living facilities where outbreaks can occur. The bug is highly contagious. C. auris can spread through contact with an affected person and through contaminated surfaces or equipment, where it can live for weeks.

Since patients are often transferred among health care settings, they can spread the fungus to other facilities. Patients recently discharged from health care settings in other countries where C. auris infections have been reported can also spread the bug.

At high risk of infection are patients who have severe underlying medical conditions, including a weakened immune system, or have been treated with multiple antimicrobial agents. Additionally, patients who have invasive tubes in their bodies, such as catheters, feeding tubes, or breathingtubes from ventilators, are more susceptible to infection.

Healthy people are at little risk of developing the infection even if they’re exposed to C. auris. However, the fungus can take up residence (colonize) for up to three months on anyone’s skin, which can shed and spread to other people at higher risk.

How dangerous is an infection?

Very. The CDC estimates that 30 to 60 percent of patients with a C. auris infection have died. But it’s important to remember that most patients were already seriously ill before they became infected.

How common is the bug?

It’s rare. According to the CDC, 911 confirmed cases of C. auris infection in the United States had been reported as of October 31, 2019, the latest date for which statistics are available. These cases have been seenmostly in New York City, New Jersey, and Chicago.

How can I prevent infection?

When visiting a patient with C. auris, you can help prevent its spread by:

  • Washing your hands thoroughly with soap and water for at least 15 seconds and drying them with a paper towel before and after your visit. If soap and water aren’t available, use an alcohol-based hand sanitizer.
  • Wearing gowns or gloves as directed by hospital staff or when caring for the patient.
  • Reminding health care professionals to wash their hands or wear gloves.

Because of its ability to colonize a patient for months, C. auris is difficult to eliminate in medical settings. It also resists many disinfectants used in facilities. Patients with C. auris infection should not share a room with another patient.

How is it treated?

Candida infections are treated with antifungal drugs. However, C. auris is resistant to two of the three major classes of antimicrobial agents, and some strains are increasingly becoming resistant to the third. Resistant infections are treated with high doses of multiple classes of antifungals.

What’s next?

There’s still much that researchers need to learn about C. auris to stop its spread. A study published in the July/August 2019 edition of MBio suggests that climate change may be playing a role in its proliferation, since C. auris has adapted to and flourished in warmer climates unlike similar fungal species. But no matter what the cause, it’s clear that scientists have their work cut out for them when it comes to containing the spread of C. auris.

This article first appeared in the December 2019 issue of UC Berkeley Health After 50.

Also see New Warning About Antibiotic-Resistant 'Superbugs.'