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Why is Candida auris a Global Threat?


Snigdha Vallabhaneni, MD, MPH, Medical Epidemiologist, Mycotic Diseases Branch at the Centers for Disease Control and Prevention, discusses the threat that is Candida auris.

Interview Transcript (slightly modified for readability)

Candida auris is a newly emerging, multidrug-resistant yeast that is causing invasive infections and has been associated with healthcare outbreaks. There are several hundred species of Candida, and several of them are pathogenic, meaning they cause disease in humans. In fact, candidemia, which is a bloodstream infection caused by [the] Candida species, is one of the most common healthcare-associated infections in the United States.

If that is not bad enough, what makes Candida auris really concerning—and a global threat—are several things. One is that it is multidrug-resistant, so almost all isolates so far are resistant to fluconazole, which is the most commonly used antifungal medication. A majority of isolates are also resistant to amphotericin [b], which is another antifungal that is used to treat fungal infections. Finally, we have [seen] isolates that are resistant to even echinocandins, which are the latest type of antifungal drugs that are available. [And] so, what is really unprecedented with Candida auris, is that they are resistant to almost all the available classes of antifungal drugs.

The second issue with Candida auris is that it is difficult to identify, so it is easily, with methods that most laboratories use, misidentified as other related Candidas. So people may not recognize that they actually have a really serious infection on hand.

Number three, what has really got us concerned, is that, unlike what we think of for most other Candida species (where it is really something that comes from Candida that basically lives in your body, colonizes people, and then causes infection when they are exposed to antibiotics in an intensive care unit or something like that), Candida auris seems to be spreading in healthcare settings [and] causing outbreaks, and that is pretty rare for Candida. There are certain species that can cause outbreaks, but in general for Candida, we do not think of them as being transmitted in a healthcare setting. We do not think of infection control, [and] that is what makes Candida auris really concerning.

[And so] to recap, Candida auris is a globally emerging threat because it is multidrug-resistant, it is difficult to identify, and because it causes healthcare-associated infections.”
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