Candida auris (C. auris) is a multi-drug resistant yeast that poses a serious threat to vulnerable populations in clinical settings. First identified in Japan in 2009, it has steadily expanded globally and continues to cause localized outbreaks.
What Is Candida auris?
C. auris is an opportunistic fungal pathogen. Unlike common yeasts, it has three defining features that make it a major concern for public health agencies:
- High Drug Resistance: Many strains are resistant to fluconazole and amphotericin B (the most common antifungals). A growing percentage of cases show resistance to echinocandins, the main class of drug used to treat it, rendering some infections pan-resistant (resistant to all three main classes of antifungals).
- Persistent Environmental Survival: Unlike most fungi, C. auris can live on hospital surfaces, bed rails, and medical devices for weeks. It resists many standard healthcare disinfectants.
- High Transmissibility: It colonizes skin quickly and spreads easily between individuals and healthcare equipment.
Why Cases Are Rising
Public health monitoring has tracked a steady year-over-year increase in clinical cases, driven by a few key factors:
- Improved Screening: Better surveillance in high-risk facilities detects cases that previously went unnoticed.
- Increased Vulnerable Populations: Rising numbers of patients require prolonged stays in intensive care or long-term nursing facilities while connected to invasive devices.
- Antifungal Overuse: Widespread use of broad-spectrum antibiotics and antifungals creates selective pressure, giving drug-resistant strains an evolutionary advantage.
Infection Risks and Symptoms
Who Is at Risk?
Healthy individuals, including children and healthcare workers, are at extremely low risk of developing an active infection. The highest risk factors include:
- Long stays in acute care or long-term nursing facilities.
- Reliance on invasive devices (ventilators, central lines, catheters, feeding tubes).
- Weakened immune systems due to cancer, surgery, or chronic illness.
- Recent extensive antibiotic or antifungal use.
Infection vs. Colonization
- Colonization: A person carries C. auris on their skin without getting sick. They can still spread the fungus to others.
- Clinical Infection: The fungus enters the bloodstream, an open wound, or an organ system.
Symptoms
Symptoms depend on where the infection occurs and can be hard to distinguish from other severe bacterial or fungal infections:
- Persistent high fever and chills that do not respond to antibiotics
- High heart rate and low blood pressure (signs of blood infection or sepsis)
- Redness, warmth, or non-healing fluid at a wound site
Prevention and Treatment
| Category | Key Actions & Clinical Approach |
| Treatment | First-line treatment relies on echinocandin antifungals. For multi-drug resistant strains, doctors use combination therapy or newer specialized antifungals. |
| Facility Prevention | Hospitals isolate colonized or infected patients, practice strict gown/glove protocols, and use EPA-registered hospital-grade disinfectants effective against spores and yeast. |
| Personal Safety | Practice frequent hand hygiene using alcohol-based sanitizer or soap and water when visiting loved ones in long-term care or hospital settings. |