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Candida auris fungal organisms

Candida auris fungal organisms. Courtesy Centers for Disease Control and Prevention.

CDC: C. auris infections nearly doubled in 2021

March 20, 2023

Infections from Candida auris (C. auris) nearly doubled from 2020 to 2021 and are spreading to more states, according to a new report from the Centers for Disease Control and Prevention (CDC).

“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 Meghan Lyman, M.D., lead author of the paper, said in a news release.

C. auris, first reported in the U.S. in 2016, spreads easily in health care settings, can cause severe disease and often is resistant to antifungal drugs, according to the report “Worsening Spread of Candida auris in the United States" (Lyman M, et al. Ann. Intern. Med. March 20, 2023). The CDC considers it an urgent antimicrobial resistance threat.

In 2021, there were 1,471 clinical cases (with an infection present) up from 756 in 2020 and 476 in 2019, when it became nationally notifiable.

The CDC also is tracking large increases in screening cases, which occur when the fungus is detected on a person, but it is not causing infection. There were 4,041 screening cases in 2021, three times as many as the previous year.

From 2019 through 2021, 17 states detected C. auris for the first time.

Authors of the report say improvements in efforts to detect C. auris may have contributed to increases. In addition, the strain on the health care system during the COVID-19 pandemic may have meant health care staff did not take proper steps to prevent infections. Cases most often occur at high-acuity post-acute care facilities.

While the report only included cases through 2021, CDC tracking data show there were an additional 2,377 clinical cases and 5,754 screening cases of C. auris in 2022.

The CDC expressed concern over small but growing numbers of cases that are resistant to antifungal echinocandins.

“Even this subtle increase is concerning because echinocandins are the first-line therapy for invasive Candida infections and most C. auris infections,” authors wrote.

The CDC recommends several infection control measures in health care settings including hand hygiene, appropriate use of transmission-based precautions, cleaning and disinfecting the patient care environment daily with recommended products, communication about a patient’s C. auris status upon transfer, screening of close contacts of case patients and laboratory surveillance of clinical specimens.


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