Potentially Deadly Fungal Superbug Reported for First Time in US Patients

Several patients with the potentially deadly fungus Candida auris have been identified in the United States, according to research published by the Centers for Disease Control and Prevention (CDC).¹

Seven patients were reported between May 2013 and August 2016, and these were the subject of a report in the CDC’s November 4 Morbidity and Mortality Weekly Report. Six additional patients have been reported since August and are currently under review, according to the researchers.

Two of the reported cases occurred in Illinois, 3 in New York, one in Maryland, and one in New Jersey. Four of these cases were fatal, although it is unknown whether the patients succumbed to the infection or to some other aspect of their illness. All of the affected patients had serious underlying medical conditions and had been hospitalized an average of 18 days when the infections were identified.

In 2 separate circumstances, identical fungal strains were found in patients treated at the same hospital or health care facility, suggesting that the infection could be spread in health care settings.

“We need to act now to better understand, contain and stop the spread of this drug-resistant fungus,” CDC Director Tom Frieden, MD, MPH said in a prepared statement.² “This is an emerging threat, and we need to protect vulnerable patients and others.”

First described in Japan in 2009, C. auris infections have since been reported in at least 10 countries. Some C. auris samples from these countries were resistant to all 3 available antifungal drug classes. Of the US cases, 71% showed some drug resistance.

Laboratory results indicate that all of the US cases were related to strains in South America and South Asia. None of the affected individuals had traveled to those areas, however, suggesting that the infections were acquired locally.

Diagnosis of C. auris infection requires specialized laboratory methods because the fungus can easily be misidentified as another type Candida, which was the case for most of the patient samples in the current report. When this occurs, patients may not receive appropriate treatment.

Those with serious health conditions and those being treated long-term in health care facilities are most at risk for infection with C. auris. For now, CDC officials recommend placing patients colonized or infected with C. auris in single rooms, using standard and contact precautions, and cleaning and disinfecting affected rooms daily using an EPA-registered, hospital-grade disinfectant that is effective against fungi.

References

1. Vallabhaneni S, Kallen A, Tsay S, et al. Investigation of the First Seven Reported Cases of Candida auris, a Globally Emerging Invasive, Multidrug-Resistant Fungus — United States, May 2013—August 2016. Morb Mortal Week Rep. 2016;65(44):1234-1237.

2. First cases of Candida auris reported in United States [news release]. Atlanta, GA: CDC Newsroom. November 4, 2016.