Candida auris has emerged globally as a multidrug-resistant fungus in hospitals. An increase in prevalence has been reported from more than 30 countries. In India, most cases of C. auris infections are reported in patients in intensive care units (ICUs). Risk factors for infection include prolonged hospitalization, tracheostomies, percutaneous endoscopic gastrostomy (PEG) tubes, and ventilators in clinical care units. Patients on broad spectrum antibiotics or immunosuppressants, transplant patients, those with comorbid conditions are particularly vulnerable to C. auris infection. Diagnosis is challenging as it has often been incorrectly identified as other Candida species with conventional diagnostic tests.

Clinically, C. auris infection has several presentations like bloodstream infections, urinary tract infection, wound infections, skin abscesses, myocarditis, meningitis and bone infections. It is often difficult to clinically differentiate C. auris infection with other types of systemic infections. Think of invasive C. auris infection, if antibiotics do not improve fever in patients with a suspected bacterial infection. C. auris is often resistant to antifungal drugs like azoles, polyenes, and echinocandins. This restricts treatment options and contributes to the high mortality associated with C. auris infection.  

Undetected C. auris infection will continue to spread undetected and cause outbreaks. Hence, it is important for healthcare workers to be aware about this infection. Along with this, advanced diagnostic methods are needed for identification. Unless detected early followed by timely initiation of treatment, invasive infection is fatal. The environment must be meticulously kept clean to prevent transmission within a healthcare facility. This article discusses the trends in the occurrence of C. auris and the current challenges of managing C. auris infection such as difficulty in diagnosis by the conventional tests, emergence of multidrug resistant and pan-resistant strains and how to prevent and control the infection with this fungus. 

Ademe M, et al. Infect Drug Resist. 2020 May 5;13:1287-94.