Treatment-Resistant Candida auris Infections Spreading Through U.S. Hospitals, CDC Warns

A lethal fungus is spreading rapidly in hospitals throughout the U.S., leading to treatment-resistant infections, federal disease experts warn.

The U.S. Centers for Disease Control and Prevention (CDC) issued a warning on March 20, highlighting growing reports of infections involving Candida auris (C. auris), an antimicrobial-resistant fungus that causes severe infections and high death rates.

The agency also released tracking data for C. auris infections, and a series of recommendations for health facilities to reduce the risk of the fungal hospital infection spreading.

Candida Auris Infection Problems

The warnings come only a few months after a study was published in the Journal of the American Medical Association, which also pointed out the growing reports of C. auris hospital infections in the U.S., and indicated that the problems were allowed to grow unchecked during the pandemic, overrunning many healthcare systems across the country.

In 2021, the number of cases of C. auris resistant to treatment tripled compared to the year before. This included cases resistant to echinocandins, an antifungal medicine most commonly used to treat the fungus.

Candida auris was first reported in the U.S in 2016. Clinical cases of C. auris have increased yearly since then, with the most rapid increases seen in 2020 and 2021. In 2022, there also was an increase in case counts as well.

A total of 3,200 clinical cases and 7,400 screening cases were reported through 2021. Clinical cases nearly tripled from 2019 to 2021. Screening cases also tripled from 2020 to 2021. Clinical cases are cases that identify the presence of the infection. Screening cases indicate the fungus was detected but did not cause infection.

From 2019 to 2021, nearly 20 states reported detecting C. auris infections for the first time.

Hospital Infection Risks

Candida auris primarily infects people with weakened immune systems and older people. The fungus is generally not a threat to healthy people, however those who are sick, have long, frequent stays in healthcare facilities, or have had invasive medical devices implanted surgically are considered a high-risk group.

The CDC warned C. auris is an urgent health threat because it is resistant to treatment and spreads easily and quickly in healthcare facilities. It leads to severe infections and high death rates.

CDC officials indicate there are several reasons for the increase in fungal infection cases. Overall, the healthcare system in the U.S. does not have adequate general infection prevention practices, allowing it to spread easily in hospitals and nursing homes. In addition, cases worsened during the pandemic due to the strain placed on hospitals and public health systems. Additionally, screening has increased, and while that increased the number of cases detected, it also has helped to prevent the spread even further, CDC officials report.

The CDC is calling for further screening practices to help identify patients infected with the fungus, and also recommended health care facilities put in place additional prevention controls to help reduce the number of clinical and screening cases overall.

“The rapid rise and geographic spread of cases is concerning and emphasizes the need for continued surveillance, expanded lab capacity, quicker diagnostic tests, and adherence to proven infection prevention and control,” CDC epidemiologist Dr. Meghan Lyman said in the press release.