Approach to the Investigation and Management of Patients With Candida auris, an Emerging Multidrug-Resistant Yeast

Abstract

Candida auris is an emerging, multidrug-resistant yeast that can spread in healthcare settings. It can cause invasive infections with high mortality and is difficult to identify using traditional yeast identification methods. Candida auris has been reported in more than a dozen countries, and as of August 2017, 112 clinical cases have been reported in the United States. Candida auris can colonize skin and persist in the healthcare environment, allowing for transmission between patients. Prompt investigation and aggressive interventions, including notification to public health agencies, implementation of contact precautions, thorough environmental cleaning and disinfection, infection control assessments, contact tracing and screening of contacts to assess for colonization, and retrospective review of microbiology records and prospective surveillance for cases at laboratories are all needed to limit the spread of C. auris. This review summarizes the current recommended approach to manage cases and control transmission of C. auris in healthcare facilities.

Keywords: Candida; communicable diseases; drug resistance; emerging; fungal; infection control; multiple.

Figure 1

Countries from which Candida auris has been reported, as of July 2017. Canada, Germany, Japan, Norway, and Kuwait have each reported a single case of C. auris. Larger numbers of cases have been reported in Colombia, India, Israel, Kenya, Oman, Pakistan, Panama, South Korea, Spain, South Africa, the United Kingdom, and Venezuela. Current case counts of C. auris for all countries are not available. United States case counts are available on the Centers for Disease Control and Prevention website. Most US cases are concentrated in the New York City and New Jersey area, though at least 7 other states have reported cases as of August 2017.