Placing Context Around Public Health Messaging, Addressing Infection Prevention for Candida auris

One thing the media does very well is quickly disseminate the news to the public; however, the messaging is not always comprehensive and can be either misleading or sensational, especially when people are just reading headlines or scanning articles. Case in point is the recent CDC warning about the fungal infection, Candida auris. Some news outlets covered it with headlines to the effect of “Deadly Fungus,” or “Cases of Antifungal Resistant Deadly Infection Spreading.”

Yes, both types of headlines are factual, but the context of who is being affected and how many people are actually succumbing to this fungal infection is lost in translation. It is important to note that C auris is mostly limited to people who are older, have weakened immune systems, are experiencing multiple medical problems, and are either hospitalized or in long-term care nursing facilities (LTCF) where these infections can colonize easily.

Meghan Lyman, MD, medical officer, Mycotic Diseases Branch, CDC, and her colleagues coauthored a study, which was published in the Annals of Internal Medicine, looking at the CDC surveillance data tracking the incidence rates of C auris. Lyman points out to the public and providers there is cause for concern, but mainly in these facilities and with these patient populations.

“People with Candida auris are very sick at baseline and require high acuity care,” said Lyman. “These are patients who are on ventilators, have invasive medical devices like central lines, feeding tubes, urinary catheters. They've often had exposure to many antibiotics and antifungal medications. And they've often had long or frequent stays in healthcare facilities. Generally, healthy people are considered low-risk for getting Candida auris and there’s not evidence that transmission in the community is a concern. Transmission mostly occurs in healthcare settings.”

Lyman explains cases increased dramatically, (95% in 2021), and there is a growing resistance to echinocandins, which is a first line of therapy for C auris. She also says the keys to stem colonization and further spread are comprehensive testing and infection prevention control measures.

“These findings emphasize that improved detection and infection control are urgently needed to prevent further spread, and without increased efforts to do this, C auris is going to continue to spread across the US and become endemic like other superbugs,” Lyman said.

The CDC stresses the importance of these medical facilities being proactive in their approach to prevention. “Implementing these practices effectively and ensuring there’s good compliances is important but not always easy. It takes a lot of work and investment of resources,” Lyman stated.

Contagion spoke to Lyman who offered further considerations for the public and medical institutions to know, how the CDC is continuing its work with understanding and preventing C auris, and the resources they are making available.