In recent years, Candida auris (C. auris), an emerging fungus with serious antimicrobial resistance (AR) implications, has shown an alarming proliferation within U.S. healthcare facilities. Data published in the Annals of Internal Medicine by the Centers for Disease Control and Prevention (CDC) shed light on this concerning trend. Equally disconcerting is the significant increase in cases resistant to echinocandins, the primary antifungal treatment recommended for C. auris infections. While generally posing no threat to healthy individuals, C. auris poses a grave risk to those who are critically ill, rely on invasive medical devices, or have prolonged stays in healthcare settings. The CDC has categorized C. auris as an urgent AR threat due to its resistance to multiple antifungal drugs, ease of transmission in healthcare environments, and the potential to cause severe infections with high mortality rates.

The Unfolding C. auris Situation

Since its initial detection in 2016, C. auris has progressively spread across the United States. By the end of 2021, a total of 3,270 clinical cases (where infection is present) and 7,413 screening cases (where the fungus is detected but not causing infection) were reported. Clinical cases have consistently increased since 2016, with the most pronounced surge occurring in 2020-2021. Significantly, case counts continued to rise in 2022. During the period from 2019-2021, 17 states reported their first-ever C. auris cases. Nationwide, clinical cases escalated from 476 in 2019 to 1,471 in 2021, while screening cases tripled in 2021, totaling 4,041. Screening plays a pivotal role in preventing further transmission by identifying carriers of the fungus, enabling the implementation of infection prevention controls.

The Role of Laboratory Tests in Detection and Identification

Laboratory tests play a crucial role in the discovery and swift identification of C. auris infections. Swift and accurate diagnosis is paramount in the battle against this formidable fungus. Specialized laboratory assays and diagnostic instruments can rapidly detect C. auris, aiding healthcare providers in making timely treatment decisions. Such tests not only confirm the presence of the fungus but also help determine its susceptibility to antifungal medications, allowing for the selection of the most effective treatment regimen.

Contributing Factors to Rising Case Counts

Several factors have contributed to the surge in C. auris cases. Inadequate infection prevention and control (IPC) practices within healthcare facilities stand out as a significant reason. Additionally, intensified efforts to detect cases, including increased colonization screening, have played a role in the rising numbers. This increase in C. auris cases coincided with the challenges faced by healthcare and public health systems during the COVID-19 pandemic, suggesting a potential exacerbation of C. auris spread during this period.

 

CDC’s Efforts and Collaborations

The CDC’s Antimicrobial Resistance Laboratory Network, a critical resource for rapidly detecting antimicrobial resistance and guiding local responses, supplied essential data for this report. Efforts to enhance laboratory capacity, backed by funding from the American Rescue Plan Act, have been instrumental in strengthening the response to C. auris. This includes expanding susceptibility testing capabilities for C. auris, involving more than 26 labs nationwide.

The CDC continues its collaboration with state, local, and territorial health departments and other partners to address this emerging public health threat. For more information on C. auris and its status as an urgent threat in the United States, refer to the Antimicrobial Resistance Threats Report. Furthermore, the World Health Organization’s fungal priority pathogen list designates C. auris as a global priority, underscoring the significance of this challenge on a global scale.

Montfort Laboratories Leads with Rapid PCR Detection for C. auris

Montfort Laboratories has introduced a Polymerase Chain Reaction (PCR) test for swift and accurate detection of the emerging fungal threat, C. auris. Compared to traditional culture methods, PCR testing offers quicker results, higher sensitivity, and the ability to detect the fungus even in non-viable samples. This technological advancement provides healthcare providers with an essential tool in the battle against this growing public health concern.