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Drug-resistant Fungal Outbreak Worries Public Health Watchdogs

Monthly Archives: April 2019


Resistant, persistent, and dangerous, especially to seniors

Candida auris, a variant of a common Candida fungal yeast found in the environment, was only identified in 2009. Since then, however, it has become a serious problem in several countries, and is spreading rapidly in hospitals and long-term care facilities throughout the U.S. C. auris is a very hardy organism. Found on the skin, clothing and bed linens, it’s usually harmless to younger, healthy individuals. However, senior citizens, immune-compromised, malnourished and chronically ill patients are at risk for infection by this fungus, causing a disease called candidemia in humans. Most troubling, it has rapidly adapted to antibiotic use, becoming multi-drug resistant.

When contracted orally, Candida causes a common disease, or candidemia, known as “thrush.” Thrush can arise when other helpful bacteria are suppressed by steroids or antibiotics, allowing Candida to flourish. Thrush can be identified by white patches on the gums and tongue. Candidemia can also develop on the skin and in the digestive tract, and while persistent, most varieties usually respond to antifungal treatment.

However, C. auris is much more dangerous than the more common Candida varieties. If introduced into the lungs or bloodstream (typically by ventilators or IV contamination) it can cause serious and sometimes fatal systemic infections. Overall, more than 33% of patients with systemic C. auris infections have died. Incidents of C. auris infections have risen rapidly in the last few years, causing concern among public health officials and medical facility administrators.

Candida is already the fourth most common cause of bloodstream infections overall, and New York State in particular has a higher than average incidence of C. auris infections, and it is a particularly virulent disease agent. According to the latest CDC bulletin, over 600 patients have been infected in 12 states, primarily in hospitals, nursing homes and long-term care facilities. Care providers such as health care aides are on the front line, and must be extra vigilant in preventing outbreaks.

C. auris is known for being almost impossible to eradicate from a hospital room. It can even survive laundering when it has colonized bed linens and clothing. Bleach and other very strong disinfectants are able to control it, so health care providers must be extra thorough when cleaning patient environments. Damp, sweaty clothing and bed linens are an ideal place for Candida to thrive, so keep patients dry. Strict handwashing and general care provider hygiene is a must for controlling this serious health threat.

It’s not clear whether C. auris has become widespread in the non-hospital community, but home health care aides must be very careful since they come into contact with both hospital and community environments. Usual handwashing and cleanliness procedures should be effective in controlling the spread of this dangerous pathogen if done properly and consistently.  

Bottom line: Candida infections are on the rise, and some can be deadly. Caregivers must keep themselves and their patients safe with good, thorough sanitation.

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