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Candida Auris

Candida auris, a multidrug resistant yeastwas initially recognized in Japan in 2009, with international distribution confirmed by 2016. The CDC first alerted clinicians and laboratories in the United States about Candida auris, in June 2016. As of March 31, 2018, there were 257 confirmed clinical cases and 30 probable cases of Candida aurisinfection in the United States. Most confirmed clinical cases were in New York (155 cases), New Jersey (59), and Illinois (25). Most probable cases were in New Jersey (23). In addition to these clinical cases, targeted screening has identified another 457 patients in four states that were colonized with Candida auris. Colonization increases the likelihood of transmission from patient to patient in a hospital setting. In addition to being resistant to multiple anti-fungal agents, this Candida species is significant because it causes invasive infections with a high mortality rate. Treatment failure of a Candida infection from any site should alert physicians to the possible presence of C. auris.

The majority of cases were bloodstream infections (54%) with the remainder from a variety of sources, including sputum and urine. Traditional identification methods used by microbiology laboratories may misidentify C. auris as another Candidaspecies or give no identification. The US Food and Drug Administration (FDA) has approved use of the Bruker Maldi Biotyper CA system (MALDI-TOF) to identify Candida auris.

Susceptibility testing and identification to species level is performed routinely on Candida species isolated from sterile body sites and upon request when isolated from other sites. An expanded yeast susceptibility panel for Candida species includes fluconazole, caspofungin, micafungin, itraconazole, and voriconazole.

Recommendations for infection prevention and control of Candida auris are available at https://www.cdc.gov/fungal/diseases/candidiasis/c-auris-infection-control.html.

 

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