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Unveiling the Growing Threat of Candida Auris: A Spotlight on the Rising Incidence and Implications for Infection Control Practices

Recent updates from the healthcare sector in Seattle have confirmed a fourth case of the fungal infection, Candida auris (C. auris), at the Kindred Hospital Seattle. This follows the initial case which was detected on January 10, subsequent to which two more cases were discovered on January 22 among patients who had initially tested negative for this pathogen. This sudden and alarming cluster of cases is the first known outbreak of C. auris in the state of Washington.

It is noteworthy, however, that C. auris predominantly poses a risk for older patients with existing health complications. As per Claire Brostrom-Smith, the manager of the Healthcare Associated Infections Program at Public Health Seattle and King County, the danger primarily lies for patients undergoing long hospital stays and requiring interventions like breathing tubes, feeding tubes, or urinary catheters.

Incidents of C. auris, a fungus known for its propensity for multidrug resistance, have surged with a dramatic 95% increase seen in the rate of cases during 2020-2021. Over the past five years, the Centers for Disease Control and Prevention (CDC) have employed the Premier Healthcare database, a comprehensive electronic healthcare data repository providing insight into hospitalizations, for tracking cases of C. auris.

An investigation concerning 192 C. auris cases from 2017–2022 conducted by the CDC’s Emerging Infectious Diseases publication offered critical findings on the nature of these hospitalizations. The research examined certain features of the C. auris hospitalizations and compared them to those without bloodstream infections, termed BSIs. Within the study, 20% of hospitalizations featured C. auris BSIs. According to the research, most BSI hospitalizations adhered to treatment guidelines and invovled echinocandin therapy, which is the first-line of therapy for C. auris.

In light of these emergent cases, an increasing concern from a public health perspective involves the growing cases, multidrug resistance, and mortality rates. However, officials are cognizant of preventive strategies and the importance of robust infection prevention control measures and screening. As a case in point, the C. auris cases in Seattle were detected through a patient safety screening program entitled the ‘Partners for Patient Safety Program’. The program screens all patients for C. auris at their admission, aiming to detect early cases and prevent further transmission. Symptomless patients can still transmit C. auris, thus early screening is a key strategy in infection control.

Aiding in an improved understanding of C. auris, Meghan Lyman, MD, a medical officer with the CDC’s Mycotic Diseases Branch, coauthored a study scrutinizing the CDC surveillance data about the incidence rates of the fungus. In line with Brostrom-Smith’s and Lyman’s messages, the CDC underscores the criticality of proactive infection prevention measures and commends healthcare facilities employing screening strategies for their role in infection control.


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