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Friday, July 8, 2016

Candida is Cropping Up in Countless Countries

I can’t say for certain that the reason we’re hearing concerns over new pathogens is from the fact that they are newly rearing their heads or if because we are further ahead in our surveillance measures so finding them faster.  I’d like to think it’s the latter.

In the last 3 of 4 weeks I have blogged about new bugs of concern (“Has the sky fallen with mcr-1”) or a known bug causing problems in an unknown way (“Does your PICU have Burkholderia?”).  This week being the 3rd with the announcement that a new species of Candida is emerging as a fungal (yeast) organism associated with invasive infections.

According to the CDC, Candida auris has made its way to the Americas after it was found in a Venezuelan hospital.  It has been linked to invasive infections in the critically ill and other immunocompromised patients who are subject to broad-spectrum antibiotics and invasive procedures.  Candida auris was first described in 2009 in Japan and since then has also been found in India, Korea, South Africa, Pakistan, Columbia, the United Kingdom and Kuwait.  The CDC has found that isolates within each region are quite similar, but are relatively different across regions. These differences suggest that C. auris has emerged independently in multiple regions at roughly the same time.  From an infection perspective C. auris is known to cause bloodstream infections, wound infections, and ear infections. It also has been isolated from respiratory and urine specimens, but it is unclear if it causes infections in the lung or bladder.
The outbreak in Venezuela included 18 critically ill patients (mostly neonates) with 5 of the 18 patients dying.  Researchers and Infection Preventionists are warning others that C. auris needs to be considered as an emergent multidrug-resistant species, which can be a source of HAIs, which has a high potential for horizontal transmission and is difficult to eradicate from the hospital environment.

While it’s early on in our understanding of Candida auris, there is some anecdotal evidence to suggest that this yeast may be able to persist for extended periods of time in the environment, making effective cleaning and disinfection using an EPA or Health Canada registered disinfectant with a Fungicidal claim for both daily and terminal cleaning important and a key to minimizing further transmission.

Here’s hoping that next week I don’t have to report on yet another new bug!

Bugging Off!


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