America's Candida Auris Epidemic

Candida auris is a drug-resistant fungal infection that colonizes human skin and causes outbreaks in healthcare settings. As of December 2022, there were confirmed cases in 28 states and D.C., with cases jumping by 95 percent between 2020 and 2021. The infection mainly affects people already in hospitals, especially those with weakened immune systems, and the mortality rate is high. The recent spike in cases in the U.S. is likely due to a combination of factors, including hospital practices and the COVID-19 pandemic. Healthcare providers must separate the patient from other patients and require that they wear gloves and gowns before caring for a patient and then discard them before caring for their next patient. Hygiene is also essential to prevent fungal infections from spreading, especially in hospitals, where organisms like Candida auris can spread easily, leading to other healthcare-associated infections.

Cases of the deadly and drug-resistant fungal infection, Candida auris, have been surging across the United States. According to a new study published in the Annals of Internal Medicine, there has been a 95 percent increase in cases between 2020 and 2021. As of December 2022, 28 states and Washington, D.C. have recorded cases of C. auris, with 17 states identifying their first C. auris case between 2019 and 2021. The U.S. Centers for Disease Control and Prevention (CDC) data shows that there were 1,471 cases of C. auris in 2021, with an estimated 2,377 clinical cases in 2022.

Candida auris is a member of a group of yeast fungi (Candida species) that typically cause minor infections in humans such as oral thrush or vaginitis. However, Candida species can sometimes invade the body and cause serious infections of the blood, heart valves, or deep organ systems.

As of December 2022, the 28 states and D.C. that have seen cases of C. auris include Alabama, Arizona, California, Colorado, Delaware, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Nevada, New Jersey, New Mexico, New York, Ohio, Pennsylvania, Tennessee, Texas, Virginia, and Wisconsin. Nevada has had the highest number of cases with 384, followed by California with 359 cases, Florida with 349, New York with 326, Illinois with 276, and Texas with 160. The other states have had fewer than 100 cases.

C. auris was first reported in Asia in 2009 and in the U.S. in 2016. CDC data indicates that the cases of C. auris jumped by 44 percent between 2018 and 2019, with a significant increase in cases between 2020 and 2021. The spread of C. auris has become a major public health concern in the United States, and it is essential to keep track of the states where the infection has been recorded to prevent its further spread.

Candida auris has caused more concern than other Candida spp due to its unusual features, including the fact that many strains are resistant to antifungal medications, it colonizes human skin, survives in the hospital environment, and causes outbreaks in healthcare settings. The fungus mainly affects people already in hospitals, especially those with weakened immune systems, and the mortality rate in the U.S. has been reported to be between 30 to 60 percent in many patients who had other serious illnesses. In a 2018 overview of research about the global spread of the fungus, researchers estimated mortality rates of 30 to 70 percent in C. auris outbreaks among critically ill patients in intensive care.

As of December 2022, there have been confirmed recorded cases of Candida auris in 28 states and D.C., with cases jumping by 95 percent between 2020 and 2021. The reasons for the recent spike in cases in the U.S. is likely due to a combination of difficulty in detecting this kind of fungal infection and hospital practices, although researchers aren’t sure of the exact cause. According to a new study in the journal Annals of Internal Medicine, the increase in C. auris cases in the U.S. was correlated to the COVID-19 pandemic, which forced a reduction in focus on C. auris, allowing its spread in hospitals and long-term care facilities.

One major concern about the increase in cases of C. auris is that it is often resistant to antifungal drugs, with many samples of C. auris having been found to be resistant to at least one class of antifungal drug. Even more alarming was a tripling in 2021 of the number of cases that were resistant to echinocandins, the antifungal medicine most recommended for treatment of C. auris infections. CDC has deemed C. auris as an urgent antimicrobial resistant (AMR) threat, because it is often resistant to multiple antifungal drugs, spreads easily in healthcare facilities, and can cause severe infections with high death rates.

In conclusion, C. auris is a concerning fungus due to its unusual features and the high mortality rate associated with it. The recent spike in cases in the U.S. is likely due to a combination of factors, including hospital practices and the COVID-19 pandemic. It is essential to keep track of the states where the infection has been recorded to prevent its further spread. With C. auris being often resistant to antifungal drugs, it is crucial to take urgent measures to combat its spread and find new treatments to combat it.

To prevent the further spread of Candida auris infection, healthcare professionals must effectively identify the infection when it occurs. Healthcare providers must separate the patient from other patients and require that they wear gloves and gowns before caring for a patient and then discard them before caring for their next patient. Hygiene is also essential to prevent fungal infections from spreading, especially in hospitals, as less than 50 percent of high-touch surfaces in healthcare settings are adequately disinfected.

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