Prevention is the best available strategy for keeping multidrug-resistant Candida auris infections from embedding in nursing homes and hospitals, according to the Association for Professionals in Infection Control and Epidemiology (APIC).
“Time is of the essence because we may soon run out of options to treat infected patients,” the organization said in a Thursday statement.
The group’s plea comes days after U.S. investigators announced the first discovery of several cases of the fungal infection that didn’t respond to available treatments. These “pan-resistant” cases appeared in clusters of infected U.S. nursing home residents and hospital patients in early 2021.
“Strong infection prevention programs are especially important in nursing homes where clusters of C. auris have already been discovered and where infection prevention and control resources have been lacking,” APIC said.
Candida auris is difficult to detect and to eradicate once embedded in a facility. It can colonize residents’ skin, which may then shed — resulting in widespread surface contamination. It can live on surfaces for up to a month.
As many as 10% of patients infected with Candida auris are likely to develop invasive infections, which are especially deadly and hard to treat, APIC said. Mortality rates in the United States range from 22% to 57%, according to the Centers for Disease Control and Prevention.
Have a plan in place
Facility operators must dedicate resources and put prevention plans in place now, APIC urged. “With few ways to treat it, preventing C. auris from spreading is our best and only option. Healthcare facilities must deploy robust infection prevention programs,” it stated.
Prevention involves screening and early identification, combined with rigorous infection control that includes cleaning and testing of environmental surfaces to ensure that rooms are clear, APIC said. Clinicians treating infected residents and patients should conduct antifungal susceptibility testing — “especially in those with treatment failure,” it advised. State or local health departments should be alerted to any new cases, the group added.
The CDC has published guidance for detecting colonized Candida auris in healthcare facilities.