By Ajay Singh, MBBS, FRCP
November 10, 2016
There are few things that wake federal health officials up at night. One is the possibility of a deadly infection that might spread throughout the United States.
In an article in the MMWR, Snigdha Vallabhaneni from the Center for Disease Control (CDC) and colleagues report seven cases in the United States of a potentially deadly drug-resistant fungal infection—Candida auris.
Candida auris is an emerging pathogenic fungus—a novel ascomycetous yeast—first isolated from the external ear canal of an inpatient in a Japanese hospital and reported in 2009; it has spread rapidly, and is now been reported from at least a dozen countries on four continents, including the US.
The fungus causes invasive infections, is associated with high mortality (in part, because it occurs in patients who are already quite ill), seems to spread in health care settings, and is often resistant to multiple antifungal antibiotics. As well, it is difficult to identify the fungus using traditional biochemical methods, and specialized methods are needed.
In fact, with routine diagnostic techniques, according to the CDC, C. auris is frequently misidentified as other yeasts (most commonly Candida haemulonii, but also Candida famata, Saccharomyces cerevisiae, and Rhodotorula glutinis).
The CDC issued a Clinical Alert to U.S. Healthcare Facilities in June 2016 asking “U.S. healthcare facilities to be on the lookout for C. auris in patients.”
The CDC says that the precise mode of transmission within the healthcare facility is not known, but suggests that C. auris might contaminate the environment of rooms of colonized or infected patients. It recommends “good infection control practices and environmental cleaning may help prevent transmission.”
1Vallabhaneni S, Kallen A, Tsay S, et al. Investigation of the First Seven Reported Cases of Candida auris, a Globally Emerging Invasive, Multidrug-Resistant Fungus — United States, May 2013–August 2016. MMWR Morb Mortal Wkly Rep. ePub: 4 November 2016.
2 Clinical Alert to U.S. Healthcare Facilities – June 2016 http://www.cdc.gov/fungal/diseases/candidiasis/candida-auris-alert.html, accessed November 4 2016.
Dr. Ajay K. Singh is the Senior Associate Dean for Global and Continuing Education and Director, Master in Medical Sciences in Clinical Investigation (MMSCI) Program at Harvard Medical School. He is also Director, Continuing Medical Education, Department of Medicine and Renal Division at Brigham and Women’s Hospital in Boston.