What Are the Symptoms of a Candida Auris Infection?

• Candida auris is a multidrug-resistant fungus that is spreading through healthcare facilities.

• People who are very sick, have long or frequent stays in healthcare facilities, or have invasive medical devices are at the highest risk of getting a C. auris infection

• Healthy individuals don't have to worry about contracting C. auris.

Candida auris (C. auris) is a dangerous fungus that's spreading through healthcare facilities at an “alarming rate,” according to the Centers for Disease Control and Prevention (CDC). The agency recorded a total of 4,041 cases of C. auris in 2021, tripling the case counts from the year prior.

C. auris is often resistant to many antifungal drugs and it can be challenging to diagnose, but it's not yet a threat to healthy individuals. People who are immunocompromised, stay in long-term care facilities, or rely on central venous catheters or feeding tubes are at the highest risk of getting a C. auris infection, according to the CDC.

“There's really no evidence that it’s out in the community affecting healthy people,” said Richard R. Watkins, MD, an infectious disease physician and professor of internal medicine at Northeast Ohio Medical University.

While the risk of community spread remains low, C. auris is a deadly fungus for patients who have long or frequent stays in healthcare facilities. Around 30-60% of patients infected with C. auris have died, according to limited data from the CDC.

Related:More Drug-Resistant Fungi Are Growing From Excessive Antibiotic Use

What Are the Symptoms of a Candida Auris Infection? Why Is It Hard to Diagnose?

Fever and chills that can't be alleviated with antibiotics are the main symptoms associated with C. auris. However, since most patients who get this infection are already very sick, it's hard to determine which of their symptoms are actually caused by the fungal infection.

“You can't really diagnose Candida auris just on symptoms. There's not one specific sign or symptom that a doctor could say, ‘you have that, then that means you have Candida auris’,” Watkins said.

C. auris infections are usually diagnosed with a blood culture test, which allows providers to determine if certain bacteria or fungi are in the blood. But C. auris is harder to identify than other types of Candida.

"Initially, when Candida auris came into our health care systems, it was difficult to diagnose because it wasn't part of testing. Now many of the labs do have diagnostic tests available to be able to determine specifically if a bloodstream infection would be due to Candida auris," said Jeniel Nett, MD, PhD, an associate professor of medicine and medical microbiology and immunology at the University of Wisconsin-Madison.

These tests aren't perfect and they can miss cases of C. auris, Nett said. Results can also take up to two weeks to be delivered from the lab to the healthcare provider.

Even if C. auris is correctly identified, treatment options are limited. Nett said she's seeing close to 90% resistance to fluconazole, one of the most common antifungal drugs used in healthcare settings. Other medications are available, but scientists are still learning how to best treat this infection since C. auris seems to be growing more resistant to anti-fungal treatments rapidly.

"The few drugs that can be used have higher toxicities and side effects than the kind of the regular treatments and unfortunately, it's very rare, but there have been cases where there are no drugs that work," Watkins said.

Related:What Is Antibiotic Resistance?

How Can You Avoid Candida Auris?

Experts are still learning exactly how C. auris is transmitted, but it seems to spread from contact with an infected person or a contaminated object or equipment.

"Candida auris lives in the environment," Watkins said. "It can live on people's skin, and if you have an indwelling device for a while, it can become colonized and then get into the bloodstream."

C. auris can stay on a patient's skin without causing infections. Proper hand hygiene is the main way to reduce the spread, but many healthcare facilities are taking extra precautions for higher-risk individuals. Providers may use different gloves and gowns for these patients or even put infected patients in a different room.

For now, experts say that healthy people don't need to be too concerned about contracting an infection.

However, Watkins said that better therapies and treatments for C. auris need to be developed and people should do what they can to stay healthy so they don't increase their risks of exposure.

"I would encourage everyone to get a COVID booster, get a flu shot because you don't want to get admitted to a hospital," he said. "In general, it's affecting people who are immunocompromised but if you're in the hospital and you have an IV line, we know that you are at increased risk for Candida."

Read Next:What to Know About Fungal Infections

Healthcare providers are still learning how to effectively prevent and treat Candida auris infections. Candida auris can only be diagnosed with specialized lab tests not by symptoms alone. If you or a loved one is immunocompromised or in a long-term care facility, consider talking to a healthcare provider about how you can reduce the risk of contracting a Candida auris infection.