Antimicrobial Resistant Organisms

WHAT IS MULTIDRUG-RESISTANT CANDIDA AURIS?

Candida auris (C. auris) is an emerging multi-drug resistant fungus that has caused increasing numbers of outbreaks and invasive infections that are associated with high mortality (>40%) in health care facilities across multiple countries.1–3 C. auris can be resistant to one or three main available classes of antifungal treatments (e.g., azoles such as fluconazole, polyenes such as amphotericin B, and echinocandins). Additionally, the organism can survive for long-periods of time on environmental surfaces and fomites, and can be resistant to some common hospital-grade disinfectants, such as quaternary ammonium compounds⁴. C. auris can live on the skin and mucous membranes of people who are colonized with it, and yet they can remain asymptomatic. Patients are at risk of acquiring C. auris if they have been hospitalized in other countries or have been in a health care facility experiencing transmission events/outbreaks. Infections with significant morbidity and mortality are more likely to occur in patients with pre-disposing risk factors such as having central venous catheters or other invasive lines/devices, receiving intensive care, treatment with broad-spectrum antibiotics or antifungals, and being immune compromised.^1,2

C. auris has the potential for transmission within health care facilities, including acute and long-term care facilities by causing healthcare-associated infections, including invasive infections with significant morbidity and mortality. The infections can be difficult to diagnose, and when diagnosed can be difficult to treat due to the limited treatment options. Both the patient and the patient’s environment can be colonized with C. auris, which can persist in the environment. Although cleaning and disinfection can remove C. auris, care must be taken to select disinfectants that are effective against the organism. Transmission from patients or the environment can potentially cause outbreaks that can be disruptive and challenging to manage. Therefore, awareness of C. auris and the recommended measures to recognize and prevent transmission are needed to address this emerging concern within health-care settings.

Early identification, adherence to routine infection prevention and control (IPC) practices, and implementation of additional measures are critical to prevent transmission of C. auris within health-care facilities. In addition to IPC control policy and procedures, the following are recommended for patient’s suspected or confirmed to have C. auris:^1,5

FOR SURVEILLANCE INFORMATION, PLEASE REFER TO:

ADDITIONAL RESOURCES:

• • Public Health Agency of Canada. Notice: Candida auris interim recommendations for infection prevention and control – Canada.ca
  • CDC. Infection Prevention and Control for Candida auris | Candida auris | Fungal Diseases | CDC