Multidrug-resistant Candida auris:
Update on Current U.S. Epidemiology, Clinical Profile, Management, and Control Strategies
Candida auris (C. auris) is an emerging fungus that presents a serious global health threat. CDC is concerned about C. auris for 3 main reasons:
- It is often multidrug-resistant, meaning multiple antifungal drugs are less or not at all effective in treating C. auris.
- It is difficult to identify with standard laboratory methods, and it can be misidentified in labs without specific technology. Misidentification may lead to inappropriate management.
- It has caused outbreaks in healthcare settings. It is important to quickly identify C. auris in a hospitalized patient so that healthcare facilities can take special precautions to stop its spread.
Most C. auris cases in the United States have been detected in the New York City area, New Jersey, and the Chicago area. Clusters of cases have also recently been described in Florida, Texas, and California. C. auris cases in the United States are originally a result of inadvertent introduction into the United States from a patient who had received healthcare in a country where C. auris has been reported. Most cases now are a result of local spread after such an introduction.
During this COCA Call, CDC presenters will
- Provide an update on the current status of C. auris
- Explain why it is a public health threat
- Review current U.S. epidemiology and resistance patterns to antifungal drugs
- Discuss clinical considerations when treating patients for C. auris
- Lay out steps for identifying and controlling C. auris.
- Date: Thursday, June 20, 2019
- Time: 2:00–3:00 p.m. (ET)
- Free continuing education (CE) is available for this COCA Call.
Nursing home-specific guidance from the CDC
Nursing homes should follow all of the same recommendations listed for general acute care hospitals and high acuity post-acute care settings. Additional considerations are as follows:
- In general, nursing home residents should be placed on Standard and Contact Precautions.
- Functional nursing home residents without wounds or indwelling medical devices (e.g., urinary and intravenous catheters and gastrostomy tubes) who can perform hand hygiene might be at lower risk of transmitting C. auris. Facilities could consider relaxing the requirement for Contact Precautions for these residents. However, in these instances, healthcare personnel should still use gowns and gloves when performing tasks that put them at higher risk of contaminating their hands or clothing. These tasks include changing wound dressings and linens and assisting with bathing, toileting, and dressing in the morning and evening.
- Nursing home residents with C. auris can leave their rooms as long as secretions and bodily fluids can be contained and the patient can perform hand hygiene prior to leaving their room.
- If residents with C. auris receive physical therapy or other shared services (e.g., physical therapy equipment, recreational resources), staff should not work with other patients while working with the affected patient. They should use a gown and gloves when they anticipate touching the patient or potentially contaminated equipment. Ideally, affected patients should be the last to receive therapy on a given day. Shared equipment should be thoroughly cleaned and disinfected after use.