Editorial – Emergence of Candida auris An International Call to Arms
Clinical Infectious Diseases January 15, 2017 V.64 N.2 P.141-143
Cornelius J. Clancy and M. Hong Nguyen
1 Department of Medicine, University of Pittsburgh,
2 VA Pittsburgh Healthcare System, and
3 University of Pittsburgh Medical Center, Pennsylvania
On June 24, 2016, the Centers for Disease Control and Prevention (CDC) issued an extraordinary alert, advising US healthcare facilities “to be on the lookout for Candida auris in patients” . The alert noted that C. auris infections had been identified in several countries since 2009. Although cases have not been described in the United States, CDC reported that a C. auris isolate from 2013 was detected during ongoing surveillance. Within a week, Public Health England (PHE) announced that C. auris was recovered from healthcare facilities in that country, and 1 hospital has been managing an outbreak involving more than 40 patients in an intensive care unit (ICU) since April 2015 . The outbreak persisted despite regular patient screening, environmental decontamination, ward closure, and other enhanced infection control interventions . In this issue of Clinical Infectious Diseases, Lockhart and colleagues describe the study that prompted the CDC alert .
Reports of C. auris infections have been published from Japan, South Korea, India, South Africa, Kuwait, and Venezuela, describing 45 patients with candidemia and 26 patients with other invasive diseases or colonization [4–11]. The earliest case to date was identified in retrospect by DNA sequencing of a Korean bloodstream isolate from 1996 . These studies established salient features of C. auris invasive infections. Candida auris is typically misidentified by commercial API-20C or Vitek-2 systems (Table 1). Infections often occur as part of nosocomial outbreaks. Patients range from neonates to the elderly and have well-recognized risk factors for invasive candidiasis. A large majority of isolates are fluconazole resistant, and amphotericin B and echinocandin resistance rates are approximately 30%–40% and approximately 5%–10%, respectively…