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An Overview on Candida auris in Healthcare Settings
Maria Luisa Cristina1,2, Anna Maria Spagnolo1,2, Marina Sartini1,2
1Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy.
Abstract:
Candida auris has become a major concern in critical care medicine due to the increasing number of immunocompromised patients and candidiasis is the most frequent cause of fungal infections. C. auris and other fungal pathogens are responsible for at least 13 million infections and 1.5 million deaths globally per year. In immunocompromised patients, infections can quickly become severe, causing wound infections, otitis and candidemia, resulting in high morbidity and mortality. The clinical presentation of C. auris is often non-specific and similar to other types of systemic infections; in addition, it is harder to identify from cultures than other, more common types of Candida spp. Some infections are particularly difficult to treat due to multi-resistance to several antifungal agents, including fluconazole (and other azoles), amphotericin B and echinocandins. This entails treatment with more drugs and at higher doses. Even after treatment for invasive infections, patients generally remain colonized for long periods, so all infection control measures must be followed during and after treatment of the C. auris infection. Screening patients for C. auris colonization enables facilities to identify individuals with C. auris colonization and to implement infection prevention and control measures. This pathogenic fungus shows an innate resilience, enabling survival and persistence in healthcare environment and the ability to rapidly colonize the patient's skin and be easily transmitted within the healthcare setting, thus leading to a serious and prolonged outbreak.
Insights
Candida auris is a growing threat in critical care, causing severe infections in immunocompromised patients. This multi-drug resistant fungus requires stringent infection control and early screening to prevent outbreaks in healthcare settings.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Critical Care Medicine
Background:
- Candida auris is an emerging multidrug-resistant fungal pathogen causing significant global health concern.
- It disproportionately affects immunocompromised individuals, leading to severe invasive infections like candidemia, wound infections, and otitis.
- High morbidity and mortality rates are associated with C. auris infections, complicated by resistance to major antifungal classes.
Purpose of the Study:
- To highlight the challenges posed by Candida auris in critical care settings.
- To emphasize the importance of infection control and screening for C. auris colonization.
- To underscore the difficulties in treating C. auris due to its antifungal resistance.
Main Methods:
- Review of clinical presentations and diagnostic challenges of C. auris.
- Analysis of antifungal resistance patterns, including azoles, amphotericin B, and echinocandins.
- Discussion of infection prevention and control strategies, including patient screening.
Main Results:
- C. auris infections present non-specifically, making early diagnosis difficult.
- Multi-drug resistance necessitates aggressive treatment with higher drug doses.
- Patients often remain colonized post-treatment, posing a persistent transmission risk.
Conclusions:
- Candida auris poses a serious threat in critical care due to its resilience, resistance, and ease of transmission.
- Effective infection control measures and patient screening are crucial to manage and prevent C. auris outbreaks.
- Further research into novel treatment and diagnostic strategies is warranted.
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