Candida auris – An Emerging Pathogen of Concern

Chong Wei Ong1,2

1 Canberra Hospital and Health Services, PO Box 11, Woden, ACT 2606; chong-wei.ong@act.gov.au

2 Calvary Public Hospital Bruce, PO Box 254, Jamison Centre, ACT 2614; chong-wei.ong@act.gov.au

 

Candida auris was first described as a novel species in 2009, following isolation from the external ear canal of a Japanese patient. Since then, there have been numerous cases associated with ear infections. In mid-2016, alerts were issued that this organism was causing significant morbidity and mortality associated with outbreaks in healthcare settings. Cases have been reported from countries on at least 5 continents, with several outbreaks also documented. There is also evidence suggesting spread between different countries. Reported clinical syndromes include bacteraemia, intravascular catheter-associated bacteraemia, catheter-associated urinary tract infection, wound infection and organ transplant-related infection. Asymptomatic colonization also occurs.

This fungus has several features which make it a potential global public health threat. Firstly, it is difficult to accurately identify. Conventional laboratory identification methods can misidentify C. auris as Candida haemulonii or some other fungal species. Accurate identification requires equipment and expertise not available in all laboratories. Secondly, many isolates are multidrug-resistant. Most isolates are resistant to fluconazole and some are additionally resistant to amphotericin B and echinocandins, thus reducing options for therapy. Thirdly, C. auris has been able to cause outbreaks in hospitals. Equipment and environmental contamination has been implicated in transmission. The organism seems able to persist in the environment for long periods. Certain commonly-used hospital disinfectants, notably quaternary ammonia compounds, are not sufficiently effective against C. auris.

This presentation will review some of the available information about this pathogen and cover a range of measures that have been applied in healthcare settings for its control.