What Is Candida Auris?
Key takeaways:
Candida is a fungus commonly found in humans.
Candida auris is a new subtype of fungus that can survive for longer periods and resist common antifungal medications.
Hospitalized and immunosuppressed people are at a higher risk for C. auris infection.
Fungi are all around us. Some forms of fungi we eat, like mushrooms. Other forms help us make fermented foods. And some forms live on our skin and inside our bodies. For example, Candida is a type of fungus that lives closely with humans and is made up of over 200 species.
But sometimes Candida can cause infection, called candidiasis. These infections range from mild to potentially life-threatening.
Candida auris (C. auris) is a new, globally emerging form of Candida. It is concerning because it can cause serious infections that are difficult to treat. Here’s why C. auris is different from other Candida species, and what you should know about it.
How is Candida auris different from other types of fungus found in or on the body?
The most common form of Candida is Candida albicans. About 50% of people have C. albicans in their gut, mouth, and/or skin. It can cause infections, but they’re usually treatable.
In 2016, the Centers for Disease Control and Prevention released an alert warning of the new emerging dangers of C. auris. This fungal subtype stands out among other Candida species for many reasons:
1) It grows well at high temperatures. Other Candida species tend to be destroyed at high temperatures. This allows C. auris to survive longer than other Candida species.
2) It is able to withstand high salt concentrations. This also prolongs its survival.
3) It is able to survive on human skin and surfaces for weeks and even tolerate disinfectants.
4) It is resistant to common antifungal medications, which makes infections difficult to treat.
5) It requires special lab methods to identify it as the source of infections.
What conditions does Candida auris cause?
C. auris can cause a variety of infections. The most mild infections are overgrowths of the fungus in the mouth or vaginal areas. More serious infections develop if the fungus gets through the skin or gut and dives deeper into organs or blood vessels. Infections of the bloodstream and organs like the kidneys, heart, and brain are dangerous.
Who’s most at risk of a Candida auris infection?
Thankfully, not everyone is at risk for candidiasis from C. auris. A few groups of people have a higher chance of developing a serious infection from C. auris. They include people who:
Are immunosuppressed (or immunocompromised) due to blood cancers (lymphoma/leukemia), organ transplant, uncontrolled HIV/AIDS, or chemotherapy treatment
Have been in intensive care (ICU) settings or skilled nursing facilities for a long period of time
Are recovering from major surgery, especially abdominal surgery and burns
Use IV drugs
Is Candida auris life-threatening?
Yes. Infections with C. auris can be life-threatening for the people mentioned above. That’s because they can be resistant to common antifungal medications. If the fungus enters the bloodstream, the chance of death is greatly increased.
How is Candida auris diagnosed and treated?
Special testing is necessary to correctly identify C. auris. As it can cause serious infections, it is not a test that can or should be done at home. The test requires multiple medical providers.
If a provider suspects a fungal infection due to C. auris, a blood culture is the next step. This test attempts to grow Candida from a blood sample. But it is not always accurate in cases of a deep C. auris infection. Sometimes, a biopsy or sample of the skin where a C. auris infection is suspected helps to make the diagnosis.
In 2018, the FDA authorized a new diagnostic test called a matrix-assisted laser desorption/ionization mass spectrometry (MALDI-TOF MS) to help identify C. auris specifically.
C. auris requires treatment with systemic antifungal medications. The medications are often given in an intravenous (IV) form. Because infections can be resistant to common antifungal medications (called the azoles), treatment requires close monitoring and care in the hospital. Common treatments include echinocandins or amphotericin B.
Infectious disease specialists can find the best treatment option by testing a sample of C. auris to various antifungals and finding a medication that the fungus is susceptible to.
The bottom line
Candida is a common fungus that lives among us. C. auris is a new emerging type that is potentially dangerous. It can survive higher temperatures and for longer periods of time, and it’s resistant to common antifungal medications.
Immunosuppressed people, people staying in intensive care units or nursing homes, and people undergoing abdominal surgeries are at higher risk for developing C. auris infection. Diagnosis and treatment require close evaluation and specialist care in a hospital.
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References
Brandt, M.E., et al. (2012). Recent taxonomic developments with Candida and other opportunistic yeasts. Current Fungal and Infection Reports.
Chow, J.K., et al. (2008). Risk factors for albicans and non-albicans candidemia in the intensive care unit. Critical Care Medicine.
Clancy, C.J., et al. (2013). Finding the "missing 50%" of invasive candidiasis: How nonculture diagnostics will improve understanding of disease spectrum and transform patient care. Clinical Infectious Disease.
Du, H., et al. (2020). Candida auris: Epidemiology, biology, antifungal resistance, and virulence. PLoS Pathogogy.
Lockhart, S., et al. (2017). Simultaneous emergence of multidrug-resistant Candida auris on 3 continents confirmed by whole-genome sequencing and epidemiological analyses. Clinical Infectious Diseases.
Morelli, M.K., et al. (2021). Candida spp. infective endocarditis: Characteristics and outcomes of twenty patients with a focus on injection drug use as a predisposing risk factor. Journal Mycoses.
Naglik, J.R., et al. (2003). Candida albicans secreted aspartyl proteinases in virulence and pathogenesis. Microbiology and Molecular Biology Review.
Welsh, R., et al. (2017). Survival, persistence, and isolation of the emerging multidrug-resistant pathogenic yeast Candida auris on a plastic health care surface. Journal of Clinical Microbiology.
