08 Nov CDC Reports On First Seven US Cases of Resistant Fungal Infection
MedicalResearch.com Interview with:
Dr. Snigdha Vallabhaneni
Mycotic Diseases Branch
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: This report is the first to describe U.S. cases of C. auris infection. C. auris is often resistant to antifungal drugs and tends to occur in hospitalized patients. In June 2016, CDC issued a clinical alert describing the global emergence of C. auris and requesting that laboratories report C. auris cases and send patient samples to state and local health departments and CDC. Since then, CDC has been investigating reports of C. auris with several state and local health departments. Seven of the cases occurred between May 2013 and August 2016 and are described in this report.
Among the seven cases detailed in the report, patients with C. auris were reported in four states: New York, Illinois, Maryland and New Jersey. All of the patients had serious underlying medical conditions and had been hospitalized an average of 18 days when C. auris was identified. Four of the patients died; it is unclear whether the deaths were associated with C. auris infection or underlying health conditions.
In two instances, two patients had been treated in the same hospital or long-term-care facility and had nearly identical fungal strains. These findings suggest that C. auris could be spread in healthcare settings.
Identifying C. auris requires specialized laboratory methods because it can easily be misidentified as another type of Candida infection, in which case patients may not receive appropriate treatment. Most of the patient samples in the current report were initially misidentified as another species of Candida.
Most of the C. auris strains from U.S. patients showed some drug resistance, making treatment more difficult. Samples of C. auris strains from other countries have been found to be resistant to all three major classes of antifungal medications. However, none of the U.S. strains in this report were resistant to all three antifungal drug classes.
Based on laboratory testing, the U.S. strains were found to be related to strains from South Asia and South America. However, none of the patients travelled to or had any direct links to those regions. Most patients likely acquired the infections locally.
MedicalResearch.com: What should readers take away from your report?
Response: CDC recommends that healthcare professionals implement strict Standard and Contact Precautions to control the spread of C. auris. Facilities should conduct thorough daily and after-discharge cleaning of rooms of C. auris patients with an EPA-registered disinfectant active against fungi.
Identifying C. auris requires specialized laboratory methods because it can easily be misidentified as another type of Candida infection, in which case patients may not receive appropriate treatment. CDC requests that laboratories that identify a confirmed or suspected C. auris isolate in the United States notify their state or local health department and CDC. More information on laboratory diagnosis and infection control can be found here:http://www.cdc.gov/fungal/diseases/candidiasis/recommendations.html.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: CDC is working hard with partners to better understand this fungus and how it spreads so we can improve infection control recommendations and help protect people. It’s important that we act now to better understand, contain and stop the spread of this drug-resistant fungus.
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Vallabhaneni S, Kallen A, Tsay S, et al. Investigation of the First Seven Reported Cases of Candida auris, a Globally Emerging Invasive, Multidrug-Resistant Fungus — United States, May 2013–August 2016. MMWR Morb Mortal Wkly Rep. ePub: 4 November 2016. DOI: http://dx.doi.org/10.15585/mmwr.mm6544e1.
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