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The emerging fungus, C. auris can cause severe multidrug-resistant illness in hospitalized patients.

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Candida Auris is a type of yeast that can cause moderate to severe infections and is often resistant to antifungal medication. It spreads when the host makes physical contact with another person or an object and can survive on surfaces for a long period of time.

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There is no common set of symptoms however some observed are;

Fever

Chills

Infections in different parts of the body

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What are the symptoms of a Candida auris infection?

Symptoms of a C. auris infection depend on where in your body the fungus infects. Some symptoms could include:

Fever.

Chills.

Lethargy (extreme tiredness).

Low blood pressure.

High heart rate (tachycardia).

Low body temperature (hypothermia).

Pain, pressure or feeling of fullness in your ear (C. auris ear infection).

Since many people who get C. auris infections are already seriously ill, symptoms of C. auris may not be noticeable. Many people carrying C. auris don't have symptoms but can still pass it to someone else.

How is Candida auris transmitted?

You get a C. auris infection from contact with someone who has it (even if they have no symptoms) or from a contaminated surface. In healthcare settings, infections can pass from person to person or through contaminated medical equipment. It can also infect you through a medical device in your body (like a central venous line or breathing tube).

Can Candida auris spread through the air?

No, experts don't believe C. auris spreads through the air. It's usually carried on your skin and travels from person to person or through contaminated objects.

What are the risk factors for Candida auris infections?

Most people who contract C. auris infections have a weakened immune system from an underlying health condition. You might be at a higher risk if you have:

A central venous line, breathing tube, feeding tube, bladder catheter or another device that goes into your body. These can allow C. auris to get into your body from the outside.

A blood cancer or diabetes.

Been in a hospital or another healthcare facility for a long time.

Had surgery recently.

Been on antibiotics for a long time, or use them frequently.

What are the complications of Candida auris infections?

If C. auris spreads to your blood, it can cause serious complications, including:

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Candida auris is a fungal infection that can cause serious illness. People who get it are usually in the hospital or long-term care facilities.

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Candida Auris is an increasingly more common source of deadly and severe infections and has proven hard to treat with current medications.

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Healthy people usually do not get invasive infections caused by Candida auris. Most people who get C. auris infections are already sick from other medical conditions. The most common symptoms of infection are fever and chills that do not improve after treatment for a suspected bacterial infection.

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Candida Auris can be treated with antifungal drugs called echinocandins; however they are resistant to medication. The best treatment is preventing further spread by having good sanitary practices and containing infected hosts. An infection caused by Candida Auris can be diagnosed with a laboratory run blood test.

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Echinocandins are the initial recommended treatment for adults and children over 2 months.

Amphotericin B deoxycholate at 1 mg/kg daily is the initial recommended treatment for infants under 2 months.

Reports of echinocandin-resistant and pan-resistant cases are increasing.

Investigational drugs may be considered for echinocandin-resistant and pan-resistant infections.

Only treat clinical infections. Do not treat patients without signs or symptoms of infection, regardless of screening test results.

Practice recommendations

Consider consulting with an infectious disease specialist.

Consider patient characteristics for antifungal selection and dosing.

Carefully monitor patient response to treatment and adjust as needed..

All cases should be reported to state or local health departments.
A dditional considerations, dosing details, and alternative treatments are explained below.
Treatment only recommended for clinical infection‎‎

Adults and children over 2 months

Based on the limited data available to date, an echinocandin drug at the dose listed below is recommended initial therapy for treatment of C. auris infections.

Echinocandin Drug

Adult dosing

Pediatric dosing ≥ 2 months of age

Anidulafungin

loading dose 200 mg IV,
then 100 mg IV daily

not approved for use in children

Caspofungin

loading dose 70 mg IV,
then 50 mg IV daily

loading dose 70mg/m ²/day IV, then 50mg/m ²/day IV
(based on body surface area)

Micafungin

100 mg IV daily

2mg/kg/day IV with option to increase to 4mg/kg/day IV in children at least 40 kg

Neonates and infants younger than 2 months of age

The initial treatment recommendation is:

Amphotericin B deoxycholate, 1 mg/kg daily
if unresponsive, consider liposomal amphotericin B, 5mg/kg daily.

In exceptional circumstances, where central nervous system involvement has been definitively ruled out, use of echinocandins may be considered with caution at the following doses:

Caspofungin - 25 mg/m²/day IV (based on body surface area)

Micafungin- 10mg/kg/day IV

Long-term infection control‎‎

Antimicrobial resistance and treatment considerations

While most strains of C. auris found in the United States are susceptible to echinocandins, reports of echinocandin-resistant and pan-resistant cases are increasing. Patients on antifungal treatment should be carefully monitored and susceptibility testing is recommended.
Echinocandin resistance
Treatment considerations for echinocandin-resistant and pan-resistant infections are based on limited evidence.

Consider treatment with liposomal amphotericin B (5 mg/kg daily) when:
Pan-resistance

Susceptibility testing indicates echinocandin resistance

Patients treated with echinocandins do not improve after 5 days.

Some strains are resistant to all three major classes of antifungals. Laboratory studies have found that combination antifungal treatment may be effective for pan-resistant infections but this was not evaluated in clinical settings.

Investigational drugs may be considered for patients with pan-resistant isolates.

Contact these companies to learn more about accessing the drugs through their expanded access programs:

Fosmanogepix: fosmanogepixEAP@WEPclinical.com

Ibrexafungerp: expandedaccess@scynexis.com

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Clinical Treatment of C. auris infections

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Echinocandins are recommended for C. auris treatment in people over 2 months with close monitoring.

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Candida auris fungal infection: What is it and who's at risk?