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Candida auris in a U.S. Patient with Carbapenemase-Producing Organisms and Recent Hospitalization in Kenya
Abstract:
Candida auris is an emerging drug-resistant yeast that causes outbreaks in health care facilities; cases have been reported from approximately 30 countries. U.S. cases of C. auris are likely the result of importation from abroad followed by extensive local transmission in health care settings (1). Early detection of Candida auris is key to preventing its spread. C. auris frequently co-occurs with carbapenemase-producing organisms (CPOs), like carbapenem-resistant Enterobacteriaceae (CRE), organisms for which testing and public health response capacity substantially increased beginning in 2017. In September 2018, the Maryland Department of Health (MDH) was notified of a hospitalized resident with CPO infection and colonization and recent hospitalization in Kenya. In light of this history, the patient was screened for C. auris and found to be colonized. Public health responses to CPOs can aid in the early identification of C. auris. As part of CPO investigations, health departments should assess whether the patient has risk factors for C. auris and ensure that patients at risk are tested promptly.
Insights
Early detection of the emerging multidrug-resistant yeast Candida auris is crucial. Public health responses for carbapenemase-producing organisms can help identify Candida auris, preventing its spread in healthcare settings.
Area of Science:
- Infectious Diseases
- Public Health
- Antimicrobial Resistance
Background:
- Candida auris is an emerging, drug-resistant yeast causing healthcare-associated outbreaks globally.
- U.S. cases often involve importation followed by local transmission in healthcare settings.
- Early detection is vital for controlling Candida auris spread.
Observation:
- Candida auris frequently co-occurs with carbapenemase-producing organisms (CPOs).
- A case in Maryland involved a patient with CPO infection and recent travel to Kenya.
- This patient was found to be colonized with Candida auris.
Findings:
- Public health responses for CPOs can facilitate early Candida auris identification.
- Screening for Candida auris should be considered in patients with CPO risk factors.
- Integrated surveillance and response for C. auris and CPOs enhance public health capacity.
Implications:
- Healthcare facilities and public health agencies must be vigilant for Candida auris.
- Leveraging existing CPO surveillance can improve Candida auris detection rates.
- Prompt identification and intervention are essential to curb Candida auris outbreaks.
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