Deadly fungus Candida auris cases detected in 27 US states — Who is at risk, symptoms, treatment

The Centers for Disease Control and Prevention (CDC) recently released findings on the deadly fungus Candida auris, saying that its strain has been detected in 27 US states so far this year. With immunosuppression being an important driver of fungal virulence, rising drug resistance and lack of effective vaccines or treatments have made Candida auris a cause for concern.

What is Candida auris?

Candida auris, also known as C auris, is a type of yeast that can cause severe illness. According to the CDC, it spreads easily among those who are very ill in healthcare facilities.

Designated by the World Health Organization as a critical-priority fungal pathogen, this deadly fungus can cause a wide range of infections. White blood cells produce reactive nitrogen species (RNS) to kill invading microbes, but this superbug fungus actively suppresses their production, leading to skin infections and severe, life-threatening infections, such as bloodstream infections.

How many cases of Candida auris in US?

The US national public health agency said there have been 3,437 cases of C auris identified as of 25 July. Compared with the previous year, there is a decline of around 1,000 detected cases. Last year, the figure stood at 4,290 during the same period. California recorded the highest number of cases, leading with 873, followed by Texas with 433 and Tennessee with 283, ABC reported, citing CDC data.

Although the rate of C auris cases continues to increase every year, the rate of increase has slowed since 2022, according to the CDC. Hence, a rise in the number of reported cases does not mean the fungus is spreading at a faster pace than usual.

How does one catch Candida auris infection?

First discovered in 1996 by Korean researchers, C auris is a communicable disease transmitted through direct contact with an infected or colonized person or indirectly via contaminated room surfaces, such as doorknobs, bedrails and shared medical equipment. Moreover, this fungus can persist on surfaces and objects for extended periods and be transmitted to patients.

It can spread directly through physical contact with patients who are infected, as well as with those who have the fungus in their skin or other body areas without symptoms. C auris was formally identified as a new species in Japan in 2009.

Who is more at risk?

Even though the mortality rate of C auris is estimated to be between 30% and 60% but, "it is hard to know how much C. auris contributed to their death compared to other pre-existing illnesses," CDC said, observing that most patients who contract the infection were already ill.

Healthy people need not worry about C. auris infections, as those with weakened immune systems and other immunocompromised people are at greater risk, according to doctors.

How to treat Candida auris

A CDC study of 8,033 C auris samples, collected between 2022 and 2023, found that more than 95% of patients were resistant to first-line antifungal treatment fluconazole. At the same time, 15% were resistant to the prescription antifungal medication amphotericin B; 1% were resistant to the antifungal medication echinocandins and fewer than 1% were resistant to all three antifungal drug classes.

Hence, multiple strains of C auris are resistant to at least one type of antifungal medication, if not several and can be treated with echinocandins, according to the CDC.