What is Candida auris (O que é Candida auris)

In Brazil, the first infection was identified in Salvador in 2020.

The overcrowding of Intensive Care Units (ICUs) during the first year of the Covid-19 pandemic, together with the reduced capacity of medical services to follow good infection control practices, facilitated the emergence of the fungus at that time in the capital of Bahia.

At the beginning of the pandemic, the ICUs were full of patients who already had chronic diseases such as chronic kidney disease, chronic obstructive pulmonary disease, diabetes, among others.

These patients spent a long time in intensive care, with a catheter in a central position, receiving mechanical ventilation and all types of antibiotic and antifungal medication.

In this context, Candida auris appeared in Brazil, explains Arnaldo Lopes Colombo, professor of infectious diseases at the Paulista School of Medicine of the Federal University of S?o Paulo (Unifesp).

Colombo states that, at the time these first cases were identified, none of the patients had a history of travel.

It was a pandemic, so we concluded that these were autochthonous cases, that is, the patients came into contact with the fungus that was present in the environment.

Retained in the hospital environment, with all the complications already mentioned, they went from being colonized to infected, he adds.

According to the National Health Surveillance Agency (Anvisa), the hospital where this first outbreak of C. auris occurred implemented all the measures to monitor and contain the spread of the fungus.

After all the actions taken, no more cases of C. auris were reported in the health service.

What is Candida auris

Candida auris is a fungal infection that can cause serious illness.

People who get it are usually in the hospital or long-term care facilities.

They often have other medical conditions or have a medical device in their body.

People with a healthy immune system usually don’t get sick from C. auris, but can transmit it to others.

Candida auris is an emerging fungal pathogen that is associated with nosocomial infections and is considered a serious global health threat.

It has numerous virulence qualities and shows multi-drug resistance patterns to common antifungal therapy used for other invasive Candida infections.

Yeast identification methods employed by laboratories typically misidentify C. auris as other yeasts making the detection and control of this pathogen difficult.

The transmission of Candida auris occurs in nosocomial settings, even in those implementing infection prevention and control measures.

In the United States, it is a nationally notifiable pathogen that allows for public health tracking and containing its spread.

Candida auris

Candida auris is a newer fungal (yeast) species that can cause human infections.

There are approximately 150 different strains of Candida currently known, and only a fraction of those cause disease in humans.

Candida auris was initially discovered on the ear of a Japanese patient in 2009 (auris is the Latin word for ear).

Candida auris is increasingly recognized as an emerging health hazard due to several of its characteristics:

It can survive for weeks on furniture, medical equipment, windows, and other surfaces.

Many common cleaning agents, including quaternary ammonium compounds that are often used as disinfectants in hospital settings, do not effectively kill Candida auris.

Candida auris is resistant to many currently available antifungal drugs, which means that infections caused by this fungus can be difficult or impossible to treat.

How does Candida auris spread?

Candida auris is found on human skin and can easily transfer to other surfaces such as curtains, floors, and cellular phones.

It can remain on these surfaces for prolonged periods of time even when disinfectants are used and can easily spread from person to person.

Many common disinfectants do not adequately kill Candida auris, so the fungus can spread throughout hospitals and other facilities even when standard cleaning protocols are followed.

Where is Candida auris found?

Candida auris is found on human skin as well as in the urine and nose.

Healthy humans can carry the fungus on their skin without having signs or symptoms of infection (this is called colonization).

Some people, including those with weakened immune systems or who are hospitalized in intensive care unit (ICU) settings, are at increased risk of developing Candida auris infection.

In addition, because Candida auris can thrive on surfaces, people who undergo invasive medical procedures such as hemodialysis, insertion of catheters into the body, or tracheostomy tube placement, are also at higher risk of contracting Candida auris infection.

What are symptoms of Candida auris?

Signs and symptoms of Candida auris infection can include fever, sepsis (a severe bloodstream infection), ear infections, abscesses, and other wound infections.

?Older adults, people who are hospitalized in ICU settings, and individuals who have chronic medical conditions such as diabetes or heart disease, are more likely to develop infection due to Candida auris.

Is Candida auris deadly?

Candida auris can cause serious infections, and over one-third of infected individuals may die.

Adults are more likely than young children or infants to die from Candida auris infection.

Candida auris is often resistant to treatment with commonly used antifungal medications, making severe infections challenging to control.

What kills Candida auris?

Disinfectants containing chlorhexidine or sodium hypochlorite (bleach) are more effective in killing Candida auris than quaternary ammonium compounds.

Hydroxide peroxide and ultraviolet-C (UVC) light can also be used to enhance killing of Candida auris.

To effectively kill Candida auris and prevent the spread of germs to other individuals, the hospital beds, sinks, and medical equipment used in the care of infected individuals should be thoroughly cleaned on a regular basis.

The United States Environmental Protection Agency (EPA) maintains a list of disinfecting products that are effective in killing Candida auris.

How do you treat Candida auris?

Candida auris is challenging to treat, as many strains of the fungus are resistant to the commonly available antifungal medications, including fluconazole (Diflucan) and amphotericin B. Some types of Candida auris are also resistant to treatment with the echinocandin class of drugs, including micafungin.

Ibrexafungerp is a newer oral antifungal drug initially approved by the United States Food and Drug Administration (FDA) in 2021.

Preliminary research suggests that ibrexafungerp may be an effective treatment for patients who are infected with resistant strains of Candida auris.

Rezafungin, an intravenous antifungal drug approved by the FDA in 2023, may also be effective in treating some Candida auris strains.

What do you do if antifungal drugs make you sick?

If unwanted or unexpected symptoms develop after taking antifungal medications such as fluconazole or ibrexafungerp, get guidance from Poison Control immediately.

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