Reasons for a closer look

An outbreak of C. auris infection at a 296-bed cardio-thoracic surgery centre in the UK was reported in October 2016. Over a 16-month period from April 2015 to July 2016, 50 cases of C. auris infection occurred in this centre. Twenty-two (44%) of these cases required antifungal treatment, nine (18%) of which had a bloodstream infection (candidemia).

An outbreak of C. auris bloodstream infections occurred in 2016 in the surgical intensive care unit of a hospital in Spain. After identification of the first case by sequencing in April 2016, 33 cases of C. auris bloodstream infection were detected by the end of November 2016. The screening of about 100 healthcare workers did not return any positive cultures. The implemented control measures included contact precautions, active surveillance for yeasts, decolonisation baths with chlorhexidine, preventive isolation of patients with a positive culture for yeasts, cohorting of cases with dedicated nursing staff, use of disposable chlorhexidine alcohol wipes before intravenous catheter manipulation, and cleaning of environmental surfaces three times per day with disposable chlorhexidine towels.

In Norway, one isolate of C. auris resistant to fluconazole was detected among isolates from invasive Candida infections sent routinely to the national reference laboratory for characterisation. Although this case of C. auris infection was diagnosed in Norway, the infection was probably acquired abroad as the concerned patient was
transferred directly from a hospital outside of the EU/EEA.

The German national reference centre for invasive fungal infections reported on its website that it detected an isolate of C. auris resistant to fluconazole isolated from a blood culture in November 2015.

These were reasons for ECDC to take a closer look at this new pathogen, Candida auris, and write a Rapid Risk Assessment.

Podcast

In this podcast, we give an overview of Candida auris. In 19 minutes, we present the key public health messages, and an interview with dr Ana Alastruey-Izquierdo, mycologist from the Mycology Reference Laboratory of the Istituto de Salud Carlos IIII in Madrid, Spain.