Just as we are learning to live with the Covid-19 threat, Candida auris, an emerging fungus considered an urgent threat, is drawing the attention of the medical profession. Infections have nearly doubled in 2021, according to new data from the US Centers for Disease Control and Prevention.
There was also a tripling of the number of cases resistant to echinocandins, the first-line treatment for Candida auris infections.
The research, published Monday in the Annals of Internal Medicine, evaluated cases of Candida auris reported to the CDC from 2016 — the year in which cases were first reported in the US — to 2021.
The study authors found that clinical cases increased each year, rising from 53 in 2016 to 330 in 2018 and then skyrocketing from 476 in 2019 to 1,471 in 2021.
Cases of Candida auris also expanded geographically. Although it was initially confined mostly to the New York City and Chicago areas, Candida auris is now present in more than half of US states. Between 2019 and 2021, 17 states identified their first cases.
According to a graphic on the CDC website, there have been 349 cases in Florida in the past year.
The CDC has called Candida auris an “urgent threat” because it is often multidrug-resistant, easily spreads through health care facilities and can cause deadly disease. It is also resistant to some common disinfectants and can be carried on people’s skin without causing symptoms, facilitating its spread to others.
The researchers wrote that the timing of this increased spread suggests that it may have been exacerbated by “pandemic-related strain on the health care and public health system.”
“The rapid rise and geographic spread of cases is concerning and emphasizes the need for continued surveillance, expanded lab capacity, quicker diagnostic tests, and adherence to proven infection prevention and control,” CDC epidemiologist Dr. Meghan Lyman, lead author of the study, said in a news release.
The organization says the expanding incidence and geographic range of fungal disease may be due to global warming and the increase of international trade and travel.
Candida auris itself first appeared as four strains on four continents between 2009 and 2015. All four strains have now been identified in the US, probably introduced through international travel, the CDC says.
Transmission of the fungus within the US is largely driven by “poor general infection prevention and control practices in healthcare facilities,” the authors of the new study say. Most spread happens in post-acute care facilities and ventilator-capable skilled-nursing facilities.
Unlike other fungi that are typically acquired from the environment, Candida auris is easily spread from person to person.
Healthy people don’t usually get sick from Candida auris, according to the CDC. Rather, it’s more likely to affect people who have serious medical problems and require long stays in health care facilities, people with weakened immune systems and people with medical devices going into their bodies, such as breathing tubes or catheters. Screening for Candida auris can help protect people at increased risk of serious infection.
