By Lilli Chiu

It’s getting increasingly difficult to keep up with all the multi-drug resistant infections that are emerging. MRSA (Methicillin-resistant Staphylococcus aureus) and strains of E.coli (Escherichia coli) are among those that are causing a global health crisis that a new United Nations report warns could cause 10 million deaths annually by 2050 if not curbed.1

A new addition to that worrisome family is Candida auris. It’s an emerging fungus that was identified in Japan in 2009 and has spread extensively in the intervening decade. First reported in New York healthcare facilities in 2013, as of the end of May, 2019, 712 cases had been reported, mainly in New York, New Jersey and Illinois.2

Candida auris is a newer strain of the Candida yeast infection. The most common symptoms are fever and chills that don’t abate when antibiotics are administered for a wrongly diagnosed bacterial infection. But even if a yeast infection is suspected, Candida auris is resistant to multiple antifungal drugs. Identifying it accurately to begin with is the issue as labs need specific technology to do the job.

One of the concerns in effectively addressing the crisis of drug-resistant infections in general is our ability to better control environments where they will spread most easily. That typically is in healthcare institutions and facilities like hospitals, nursing homes and hemodialysis centers where the Candida auris outbreaks are most often occurring.

The fungus tends to prey on vulnerable patients with weakened immunity due to diseases like cancer or who are recovering from surgery. It can also occur among those who have spent time in nursing homes, with breathing or feeding tubes for extended periods, and colonizes easily on surface areas. Between 30% to 60% of patients infected with Candida auris have died.3

Recent lab studies have enhanced our understanding of ways healthcare establishments can reduce the risk of Candida auris outbreaks. Among measures to effectively limit patient-to-patient as well as patient-to-healthcare employee exposures:4

  • Patients who have contracted the infection should be isolated in a single-patient room. If there’s a shortage of single rooms, they may be placed in rooms with others who also have Candida auris, but not other multi-drug resistant infections.
  • Hand hygiene among healthcare practitioners is essential when Candida auris has been detected among patients. Gloves are important for reducing hand contamination, but are not a substitute for soap and water and alcohol-based hand sanitizer use (before the gloves are put on).
  • The buddy system should always be used in following disinfecting as well as monitoring staff to ensure that protocols are being followed. Doubling up is the rule of thumb: Each team member should use double gloves, gowns and booties. Once an area (whether bedside tables, bedrails or nursing carts) has been positively tested for Candida auris, it should be cleaned twice daily, morning and evening. Swab tests should be conducted before and after each disinfection.
  • Research and lab studies on the most effective disinfectants against the fungus are constantly changing. The U.S. Centers for Disease Control (CDC) recommends EPA-registered, hospital-grade disinfectants that are effective in deactivating bacterial spores.5

The saying goes that an ounce of prevention is worth a pound of cure, and that just may be true today more than ever as our “cures” seem to be losing some of their punch. It certainly makes the case for extra measures of care as multi-drug resistant bugs continue to multiply.

HUB International’s team of healthcare specialists is ready to help your organization assess and manage risks in today’s medical environment.