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Candida auris - drug resistant germ - CDC is alerting U.S. healthcare facilities to be on the lookout for C. auris in their patients.

sharon sanders

Editor-in-Chief & President
link from a friend of FluTrackers

[FONT=&quot]A Mysterious Infection, Spanning the Globe in a Climate of Secrecy[/FONT]


The rise of Candida auris embodies a serious and growing public health threat: drug-resistant germs.

https://www.nytimes.com/2019/04/06/h...gtype=Homepage




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CDC information:



General Information about Candida auris

[FONT=&quot]Healthcare facilities in several countries have reported that a type of yeast called Candida auris has been causing severe illness in hospitalized patients. In some patients, this yeast can enter the bloodstream and spread throughout the body, causing serious invasive infections. This yeast often does not respond to commonly used antifungal drugs, making infections difficult to treat. Patients who have been hospitalized in a healthcare facility a long time, have a central venous catheter, or other lines or tubes entering their body, or have previously received antibiotics or antifungal medications, appear to be at highest risk of infection with this yeast.[/FONT]
[FONT=&quot]Specialized laboratory methods are needed to accurately identify C. auris. Conventional laboratory techniques could lead to misidentification and inappropriate management, making it difficult to control the spread of C. auris in healthcare settings.[/FONT]
[FONT=&quot]Because of these factors, CDC is alerting U.S. healthcare facilities to be on the lookout for C. auris in their patients.[/FONT]
[FONT=&quot]CDC and partners continue to work closely; click here for the latest information on Candida auris. To learn more about Candida auris, read the Q&A below and:[/FONT]
[FONT=&quot] [/FONT]

Why is CDC concerned about C. auris infections?

[FONT=&quot]CDC is concerned about C. auris for three main reasons:[/FONT]
  1. It is often multidrug-resistant, meaning that it is resistant to multiple antifungal drugs commonly used to treat Candida infections.
  2. It is difficult to identify with standard laboratory methods, and it can be misidentified in labs without specific technology. Misidentification may lead to inappropriate management.
  3. It has caused outbreaks in healthcare settings. For this reason, it is important to quickly identify C. auris in a hospitalized patient so that healthcare facilities can take special precautions to stop its spread.
What types of infections can C. auris cause?

[FONT=&quot]C. auris has caused bloodstream infections, wound infections, and ear infections. It also has been isolated from respiratory and urine specimens, but it is unclear if it causes infections in the lung or bladder.[/FONT]
How is C. auris infection diagnosed?

[FONT=&quot]Like other Candida infections, C. auris infections are usually diagnosed by culture of blood or other body fluids. However, C. auris is harder to identify from cultures than other, more common types of Candida. For example, it can be confused with other types of yeasts, particularly Candida haemulonii. Special laboratory tests are needed to identify C. auris. For more information, please see the Recommendations for Laboratorians and Health Professionals.[/FONT]
Who is at risk for infection from C. auris?

[FONT=&quot]Limited data suggest that the risk factors for Candida auris infections are generally similar to risk factors for other types of Candida infections. These risk factors include recent surgery, diabetes, broad-spectrum antibiotic and antifungal use. People who have recently spent time in nursing homes and have lines and tubes that go into their body (such as breathing tubes, feeding tubes and central venous catheters), seem to be at highest risk for C. auris infection. Infections have been found in patients of all ages, from preterm infants to the elderly. Further study is needed to learn more about risk factors for C. auris infection.[/FONT]
When was C. auris first reported?

[FONT=&quot]C. auris was first identified in 2009 in Japan. Retrospective review of Candida strain collections found that the earliest known strain of C. auris dates to 1996 in South Korea. CDC considers C. auris an emerging pathogen because increasing numbers of infections have been identified in multiple countries since it was recognized.[/FONT]
How did C. auris get its name?

[FONT=&quot]Auris is the Latin word for ear. Despite its name, C. auris can also affect many other regions of the body and can cause invasive infections, including bloodstream infections and wound infections.[/FONT]
Where have C. auris infections occurred globally?

[FONT=&quot]C. auris infections have been reported from over 20 countries, including the United States. Because identification of C. auris requires specialized laboratory methods, infections likely have occurred in other countries but have not been identified or reported. Click here for a map of countries with reported cases.[/FONT]
How did C. auris infection spread globally?

[FONT=&quot]CDC conducted whole genome sequencing of C. auris specimens from countries in the regions of eastern Asia, southern Asia, southern Africa, and South America. Whole genome sequencing produces detailed DNA fingerprints of organisms. CDC found that isolates within each region are quite similar to one another, but are relatively different across regions. These differences suggest that C. auris has emerged independently in multiple regions at roughly the same time.[/FONT]
Would someone be likely to get a C. auris infection if they travel to any of these countries?

[FONT=&quot]It is unlikely that routine travel to countries with documented C. auris infections would increase the chance of someone getting sick from C. auris. Infections have occurred primarily in patients who were already in the hospital for other reasons. People who travel to these countries to seek medical care or who are hospitalized there for a long time may have an increased risk for C. auris infection. [/FONT]
Have C. auris infections occurred in the United States?

[FONT=&quot]Cases of C. auris infections have been reported in the United States. As laboratories continue to look for this fungus, it is likely that more cases will be reported. Click here for a map of cases in the United States.[/FONT]
What should someone do if they suspect they have a C. auris infection?

[FONT=&quot]CDC recommends that anyone who believes they have any fungal infection or healthcare-associated infection see a healthcare provider.[/FONT]
Are C. auris infections treatable?

[FONT=&quot]Most C. auris infections are treatable with a class of antifungal drugs called echinocandins. However, some C. auris infections have been resistant to all three main classes of antifungal medications, making them more difficult to treat. In this situation, multiple classes of antifungals at high doses may be required to treat the infection. Treatment decisions should be made in consultation with a healthcare provider experienced in treating patients with fungal infections.[/FONT]
Can a person die from infection with C. auris?

[FONT=&quot]Yes. Invasive infections with any Candida species can be fatal. We don’t know if patients with invasive C. auris infection are more likely to die than patients with other invasive Candida infections. Based on information from a limited number of patients, 30–60% of people with C. auris infections have died. However, many of these people had other serious illnesses that also increased their risk of death.[/FONT]
How does C. auris spread?

[FONT=&quot]C. auris can spread in healthcare settings through contact with contaminated environmental surfaces or equipment, or from person to person. More work is needed to further understand how it spreads.[/FONT]
How can the spread of C. auris be prevented?

[FONT=&quot]Please see the Recommendations for Laboratorians and Health Professionals.[/FONT]
What is CDC doing to address C. auris?

[FONT=&quot]CDC is providing guidance for clinicians and infection control personnel. For more information, please see the Recommendations for Laboratorians and Health Professionals. CDC also is working with state and local health agencies, healthcare facilities, and clinical microbiology laboratories to ensure that laboratories are using proper methods to detect C. auris and know the limitations of certain tests for detecting C. auris.[/FONT]

[FONT=&quot]Page last reviewed: [/FONT]
[FONT=&quot]December 21, 2018[/FONT]


https://www.cdc.gov/fungal/candida-a...ris-qanda.html
 
Candida Auris likely to represent the first of a new type of infection threat, namely the evolution of novel pathogenic organisms as a direct result of global warming. As average surface temperatures increase, the protective barrier of higher core body temperatures begins to diminish, opening up the opportunity for humans to host infections and diseases from sources previously unknown in history.
 
[FONT=&quot] [h=1]Tracking Candida auris[/h] [/FONT]
[FONT=&quot] July 12, 2019: Case Count Updated as of May 31, 2019


[/FONT]

[FONT=&quot] Candida auris is an emerging fungus that presents a serious global health threat. C. auris causes severe illness in hospitalized patients in several countries, including the United States. Patients can remain colonized with C. auris for a long time and C. auris can persist on surfaces in healthcare environments. This can result in spread of C. auris between patients in healthcare facilities.
Most C. auris cases in the United States have been detected in the New York City area, New Jersey, and the Chicago area. Strains of C. auris in the United States have been linked to other parts of the world. U.S. C. auris cases are a result of inadvertent introduction into the United States from a patient who recently received healthcare in a country where C. auris has been reported or a result of local spread after such an introduction.
Candida auris was made nationally notifiable at the 2018 Council for State and Territorial Epidemiologists (CSTE) Annual Conference. For the updated case definition and information on the nationally notifiable condition status, please see the 2018 CSTE position statement pdf icon[PDF ? 16 pages]external icon.


[COLOR=#FFFFFF !important]U.S. Map: Clinical cases of Candida auris reported by U.S. states, as of May 31, 2019

map.png
Cases are categorized by the state where the specimen was collected. Most probable cases were identified when laboratories with current cases of C. auris reviewed past microbiology records for C. auris. Isolates were not available for confirmation. Early detection of C. auris is essential for containing its spread in healthcare facilities.
[h=4]Clinical cases of Candida auris reported by U.S. states, as of May 31, 2019[/h] [TABLE="class: table table-bordered, width: 768"]
[h=4]Clinical cases of Candida auris reported by state, United States[/h] [TR]
State Number and type of clinical Candida auris cases reported [/TR]
[TR]
Confirmed Probable [/TR]
[TR]
[TD]California[/TD]
[TD]5[/TD]
[TD]0[/TD]
[/TR]
[TR]
[TD]Connecticut[/TD]
[TD]1[/TD]
[TD]0[/TD]
[/TR]
[TR]
[TD]Florida[/TD]
[TD]20[/TD]
[TD]0[/TD]
[/TR]
[TR]
[TD]Illinois[/TD]
[TD]180[/TD]
[TD]4[/TD]
[/TR]
[TR]
[TD]Indiana[/TD]
[TD]1[/TD]
[TD]0[/TD]
[/TR]
[TR]
[TD]Maryland[/TD]
[TD]3[/TD]
[TD]0[/TD]
[/TR]
[TR]
[TD]Massachusetts[/TD]
[TD]8[/TD]
[TD]0[/TD]
[/TR]
[TR]
[TD]New Jersey[/TD]
[TD]124[/TD]
[TD]22[/TD]
[/TR]
[TR]
[TD]New York[/TD]
[TD]336[/TD]
[TD]4[/TD]
[/TR]
[TR]
[TD]Oklahoma[/TD]
[TD]2[/TD]
[TD]0[/TD]
[/TR]
[TR]
[TD]Texas[/TD]
[TD]4[/TD]
[TD]0[/TD]
[/TR]
[TR]
[TD]Virginia[/TD]
[TD]1[/TD]
[TD] 0[/TD]
[/TR]
[TR]
[TD]TOTAL[/TD]
[TD]685[/TD]
[TD]30[/TD]
[/TR]
[/TABLE]
Beyond the clinical case counts reported above, an additional 1341 patients have been found to be colonized with C. auris by targeted screening in ten states with clinical cases.
CDC will update case counts monthly.





[/FONT][/COLOR]
[FONT=&quot] What are clinical cases?


What are probable clinical cases?


What are colonization/screening cases?



CDC encourages all U.S. laboratories that identify C. auris to notify their state or local public health authorities and CDC at candidaauris@cdc.gov. CDC is working closely with public health and healthcare partners to prevent and respond to C. auris infections. The CDC-sponsored Antibiotic Resistance Laboratory Network (ARLN) will help improve detection and response to C. auris nationwide.



[/FONT]

[FONT=&quot] [COLOR=#FFFFFF !important]Countries from which Candida auris cases have been reported, as of May 31, 2019
world-map.png
  • Single cases of C. auris have been reported from Austria, Belgium, Chile, Costa Rica, Iran, Malaysia, the Netherlands, Norway, Switzerland, Taiwan, Thailand, and the United Arab Emirates.
  • Multiple cases of C. auris have been reported from Australia, Canada, China, Colombia, France, Germany, India, Israel, Japan, Kenya, Kuwait, Oman, Pakistan, Panama, Russia, Saudi Arabia, Singapore, South Africa, South Korea, Spain, the United Kingdom, the United States (primarily from the New York City area, New Jersey, and the Chicago area) and Venezuela; in some of these countries, extensive transmission of C. auris has been documented in more than one hospital.
  • U.S. cases of C. auris have been found in patients who had recent stays in healthcare facilities in India, Kenya, Kuwait, Pakistan, South Africa, the United Arab Emirates, and Venezuela, which also have documented cases.
  • Other countries not highlighted on this map may also have undetected or unreported C. auris cases.


[/FONT][/COLOR]

https://www.cdc.gov/fungal/candida-auris/tracking-c-auris.html
 
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