Candida auris
Reporting Obligations
Confirmed and suspected cases shall be reported to the local Health Unit.
Epidemiology
Aetiologic Agent
Candida auris is a type of yeast that can cause invasive and severe illness and spreads easily among patients in healthcare facilities. C. auris can cause a range of infections from superficial (skin) infections to more severe, life-threatening infections, such as bloodstream infections.
C. auris is often resistant to antifungal medications. Resistant infections can be difficult, and sometimes impossible, to treat.
Clinical Presentation
C. auris can infect the bloodstream, wounds, and cause other infections including respiratory and urine. Patients may also be colonized.
Modes of Transmission
Modes of transmission can vary. C. auris can spread via surfaces and objects like bedrails, doorknobs and blood pressure cuffs easily, as it can live on surfaces and objects and remain on a patient’s skin or body sites for a long period of time whether or not they have symptoms. Early evidence suggests that C. auris is mainly transmitted by direct contact with mucous membranes or damaged skin, such as use of central venous or urinary catheters, recent surgery and parenteral nutrition. Transmission by direct and indirect contact has frequently been reported in outbreak settings, including transmission through shared medical equipment and possibly mother to newborn. Injection is also a possible mode of transmission.
Incubation Period
The incubation period is up to 41-61 days.
Risk Factors/Susceptibility
C.auris more often affects patients with severe underlying medical conditions and those requiring complex medical care and invasive medical devices, for example: breathing tubes, feeding tubes, catheters in a vein, urinary catheters. Risk factors include: prolonged exposure to broad-spectrum antibiotics, indwelling medical devices, diabetes mellitus, prolonged ICU stay, haemodialysis, patient immunocompromised, admission to a hospital or LTC home outside of Canada, transfer from a health care facility with an ongoing C. auris outbreak. C. auris is considered less risk for health people.
Diagnosis and Laboratory Testing
Please refer to Public Health Ontario’s Labstract for C. auris reference identification and susceptibility testing found here.
Treatment and Case Management
Management of a Single New Case of Candida auris Algorithm.
Patient Information
Additional Resources
References
Ministry of Health and Long-Term Care, Infectious Diseases Protocol, 2022.