A deadly fungus infection? What we know about Candida Auris spread in the South

Joyce Orlando
Nashville Tennessean

Since 2016, Candida auris, a deadly fungal infection, has been on the rise and in recent months making itself known in some health care facilities across the South.

The Centers for Disease Control and Prevention calls it an “urgent threat” after a new study showed it has been spreading at an “alarming rate” throughout health care facilities.

“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,” said lead author in the CDC's latest study Dr. Meghan Lyman, an epidemiologist at the CDC.

According to the study, healthcare facilities, especially long-term facilities like nursing homes, have seen the most dramatic increase in cases. Mississippi saw an outbreak of it in such facilities, according to state health officials.

“Unfortunately, multi-drug resistant organisms such as C. auris have become more prevalent among our highest risk individuals, such as residents in long-term care facilities,” said Tammy Yates, spokesperson for the Mississippi State Department of Health said.

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What is candida auris fungal infection?

C. auris, Candida auris, is a type of yeast that can cause high morbidity and mortality, outbreaks in healthcare settings and can be highly drug resistant, according to the Tennessee Department of Health. Multiple cases of the fungus have been reported in the state in 2021, according to the CDC.

People can be asymptomatic for long periods of time, even after an active infection is resolved. A person is considered infected with the fungus indefinitely regardless of prior treatment. The risk of C. auris infection in healthy individuals, including healthcare personnel, is extremely low.

Candida auris can infect the bloodstream and even cause death by invading the blood, heart and brain, the CDC said. More than 1 in 3 patients die from such an infection.

The fungus is also dangerous because it’s often resistant to antifungal medicines commonly used to treat infections.

This 2016 photo made available by the Centers for Disease Control and Prevention shows a strain of Candida auris cultured in a petri dish at a CDC laboratory.

What caused the rise in the deadly fungs?

The CDC cited many reasons for the increase, including poor general infection prevention and control practices in health care facilities, enhanced efforts to detect cases and strained health care and public health systems during the COVID-19 pandemic.

When and where was Candida auris first detected?

According to the CDC, C. auris was first identified in 2009 in Japan. Since then, at least 30 other countries have detected the deadly fungus strand.

“If[the fungi]get into a hospital, they are very difficult to control and get out,” William Schaffner, a professor of medicine in the infectious diseases division of Vanderbilt University Medical Center, told The Washington Post. “They can persist, smoldering, causing infections for a considerable period of time despite the best efforts of the infection control team and everyone else in the hospital.”

How is Candida auris or C. auris detected?

It’s difficult to identify without specialized laboratory technology and is often mistaken for other infections.

What states have cases of Candida auris?

Reports of the deadly fungus have come in from multiple across the United States. In the South for 2022, Tennessee, Alabama, Georgia, Mississippi and Louisiana reported cases of the deadly fungal infection, according to the CDC.

  • Tennessee: 8 cases
  • Georgia: 12 cases
  • Mississippi: 5 cases
  • Alabama: 6 cases
  • Louisiana: 10 cases

North and South Carolina had no reported cases of it.

Candida auris cases have been on the rise each year since it was first reported in 2016. Its most rapid rise was 2020 to 2021, according to the study published Monday in the Annals of Internal Medicine.

  • Cases detected through screening tripled from 2020 to 2021, totaling 4,041.
  • Cases that caused infection rose from 476 in 2019 to 1,471 in 2021.
  • 17 states identified their first case of C. auris ever between 2019 and 2021.