How does Candida auris relate to Candida? How is it spread, treated, and prevented?

What is Candida auris?

Candida auris is a type of Candida, which belongs to the category of fungi. Candida is generally present in the mucous membranes of the human body, including the mouth, skin, intestines, and female genitalia. Candida infections in the community usually cause vaginal yeast infections, urinary tract infections, etc. Candida auris was first discovered in the ear canal of a patient in Japan in 2009, hence the name “auris,” but it can also inhabit other organs in the human body. Currently, most Candida auris is not found in the ear canal.

Why do people get infected with Candida auris?

Candida auris mainly exists in the hospital environment, and carriers transmit the fungus to others through shared objects such as bed rails, blood pressure cuffs, thermometers, and other medical devices. Most Candida auris carriers have no symptoms, but when hospitals find infected patients, they will conduct tracking and screening to find other carriers. Candida auris generally does not affect healthy people, but people with weak immunity, such as long-term patients, cancer patients, and patients taking immunosuppressive drugs, are more likely to be infected.

What are the consequences of Candida auris infection?

When people come into contact with Candida auris, if it only stays on the surface of the skin, it generally does not cause infection or symptoms. However, if there are wounds on the skin or if the body is connected to catheters, such as urinary catheters, central venous catheters, or other invasive medical devices, Candida auris has the opportunity to enter the blood and cause invasive infections, which can cause symptoms such as dizziness, fever, and low blood pressure. People with weaker immunity may even develop sepsis. Data shows that the mortality rate for invasive Candida auris infection can be as high as 30% to 60%.

Is it difficult to treat Candida auris?

The symptoms of invasive Candida auris infection are similar to those of other bacterial sepsis, such as fever and decreased blood pressure. If the doctor only prescribes antibiotics instead of antifungal drugs early on, it may not be effective. If the doctor waits until the blood is cultured and confirms it is Candida auris, then prescribes antifungal drugs, it may already delay the treatment.

Candida auris is also resistant to multiple drugs, and commonly used antifungal drugs may not be effective, or multiple antifungal drugs may need to be used simultaneously. According to foreign experience, currently, there are three antifungal drugs that can be used to treat Candida auris, namely echinocandins, amphotericin B, and fluconazole. However, Candida auris has about 90% and 30% resistance to fluconazole and amphotericin B, respectively, which reduces the effectiveness of treatment. As for Candida auris’s resistance to echinocandins, it is less than 5%, making it the most effective way to deal with Candida auris, and with fewer side effects.

If a patient develops invasive Candida auris infection, they usually need to take antifungal drugs for two weeks. If a patient is only a carrier of Candida auris and does not have an infection or obvious symptoms, antifungal drugs are not necessary.

How to prevent Candida auris?

Candida auris is robust and general disinfectants may not eliminate it. Diluted bleach (1:49) can be used to remove Candida auris from the environment. However, foreign reports indicate that once Candida auris inhabits the environment of medical facilities, it is difficult to completely eliminate it. To prevent Candida auris, the most important thing is still to pay attention to personal hygiene, wash hands frequently, maintain a healthy lifestyle and eating habits, control existing diseases, and thereby enhance immunity.