Candida auris is a multidrug-resistant fungus that causes serious healthcare-associated infections. Earlier this year, in March 2023, the Centers for Disease Control and Prevention (CDC) designated it an urgent threat as a result of antimicrobial resistance. With infections resulting in up to 50% mortality rates, the fungus has become a major threat against health systems worldwide. Candida auris was first identified in Japan in 2009. Since then, it has quickly spread to more than 40 other countries, including the United States where it was first detected in 2016.
The strain’s resistance to multiple antifungal drugs and difficulty in laboratory identification have contributed to its rapid spread and the potential underestimation of its presence. The CDC’s recent declaration underscores the growing urgency for increased education and efforts to prevent this dangerous emerging infectious disease.
Rising Threat in Healthcare Settings
Candida auris is well-known for triggering invasive infections in healthcare settings, especially among patients with compromised immune systems. Its estimated 40 percent mortality rate reminds us of the need for efficient containment strategies to prevent transmission. Health Canada has voiced these concerns, calling attention to the fungus’s global threat level.
“Candida auris is a species of fungus that can cause healthcare-associated invasive infections and outbreaks, posing a serious threat to global human health,” – Health Canada
In North America, the southeast spread of Candida auris has been especially alarming. The first confirmed U.S. case didn’t appear until 2016. As of 2023, the invasive fungus had already been found in over 4,514 Americans. Canadian healthcare facilities have been hit hard, with the Public Health Agency of Canada reporting outbreaks as recently as 2012.
Challenges of Detection and Resistance
One of the biggest obstacles in handling Candida auris is its multidrug resistance. This naturally fluctuating characteristic complicates detection, complicates treatment, and raises the risk of severe or extreme outcomes for those infected. The strain’s resilience comes from its impressive ability to evade standard laboratory detection methods, which can result in underreporting.
In May 2017, U.S. doctors recorded the first case of a multidrug-resistant Candida auris infection. This was the infection that caused trouble for a Canadian patient who was hospitalized in India. The outbreak highlighted the fungus’s potential for worldwide spread and the importance of strict surveillance efforts.
“People who are very sick, have invasive medical devices, or have long or frequent stays in healthcare facilities are at increased risk.” – CDC
In health care settings, particularly those with more vulnerable patient populations, Candida auris has been responsible for large and costly outbreaks. Researchers investigating its effects in Canada, including in the college sector, reported that Canadian institutions have not been spared from the spread.
“Spread of C. auris in healthcare facilities has not spared Canadian institutions.” – Researchers of a study entitled First reported outbreak of the emerging pathogen Candida auris in Canada
Global Spread and Response
Candida auris first appeared more than 10 years ago. Since then it has been an overwhelming adversary to international healthcare systems. Its existence in over 40 countries, while a testament to its widespread adoption and durability throughout different ecosystems, further proves its invasive nature.
The record number of cases reported since the start of 2023 underscores the urgency of a unified global response to address this crisis. In November, the CDC classified Candida auris as an urgent threat. As a consequence of this designation, immediate actions should be taken to improve surveillance, improve existing diagnostic capacity, and expedite the development of novel antifungal treatments.
