The findings, which researchers presented at the annual conference of the American Society for Microbiology in June 2019, confirmed that the superbug called Candida auris (C. auris) not only colonizes the skin, but persists on surfaces. “Our findings emphasize the importance of environmental cleaning and disinfection, including of high-touch surfaces like bed rails,” says an author of the study, Joseph Sexton, PhD, a microbiologist in the Mycotic Diseases Branch of the Centers for Disease Control and Prevention (CDC). Over the past few years, C. auris has been on the rise across the globe. In the United States alone, cases have more than doubled in one year, from 257 in the spring of 2018 to 654 so far in 2019, according to the CDC. The fungus is primarily found in hospitals and other healthcare environments where it attacks patients with weakened immune systems, often infecting wounds, the blood, brain, heart, and ear. More than a third of patients with C. auris die, according to the Centers for Disease Control and Prevention (CDC). In addition to producing serious illness, this hardy organism earns its reputation as a “superbug” because it resists treatment with available antibiotics and is highly transmittable. RELATED: What Is MRSA? Everything You Need to Know About the Superbug
C. Auris Remains on Previous Patients’ Beds, Study Authors Found
Sexton and his fellow scientists collaborated with Chicago Department of Public Health to collect 100 samples from a nursing facility with an ongoing C. auris outbreak. They analyzed specimens associated with 28 of the 69 residents, who had an average age of 60. Investigators discovered that higher levels of C. auris on patients’ skin correlated with higher levels of C. auris on patient beds. Individuals who tested 100 percent positive for C. auris had culture-positive bed samples. Researchers noted that the fungus even lived on beds that were previously, but no longer, occupied by patients with C. auris. “These findings supported our hypothesis that patients are actively shedding C. auris cells into their environment,” says Dr. Sexton. “There was a clear relationship between the amount of C. auris on skin and the nearby environment.” RELATED: CDC Says Hospitals Are Making Progress Against ‘Superbugs’
Why the Findings Signal a Need for Better Infection Control
Scientists were initially surprised to detect the fungus on windowsills, but they later determined the reason: Often, patients use windowsills as shelves, so it would make sense for the organism to spread there too. C. auris fungus can also survive for weeks on IV poles and other medical equipment. “This emphasizes that we absolutely have to pay intense attention to absolutely every surface when we decontaminate rooms,” says William Schaffner, MD, an infectious disease specialist and a professor of preventive medicine and health policy at the Vanderbilt University School of Medicine in Nashville, Tennessee. Overall, the investigation highlights that infection control workers have to be more comprehensive in their cleaning procedures, says Schaffner, who was not involved in the study. “When you have a Candida auris outbreak, it notches up the importance of infection control,” he says. RELATED: 7 Scary Drug-Resistant Infections
What Can You Do if You or a Loved One Is Hospitalized?
The CDC advises healthcare facilities to thoroughly clean rooms of patients who carry C. auris every day using a disinfectant registered by the Environmental Protection Agency. While patients can only do so much to ensure that their rooms are properly cleaned, they can take steps when it comes to their own hygiene. Dr. Schaffner stresses that regular handwashing can help limit the spread of disease, and visitors should rigorously wash hands when entering and leaving a patient’s room. RELATED: 5 Steps to Effective Handwashing
How Researchers Plan to Further Investigate C. Auris
This study involved a single nursing home unit and tested a limited range of environmental surfaces. Not only is C. auris relatively new, having been discovered in 2009, per the CDC, but Sexton says that more research is needed regarding which healthcare surfaces — including on mobile equipment — contribute most to C. auris transmission. Further investigation may also reveal what factors influence the degree of fungus colonization on a patient.
What Else to Know About C. Auris and Candida Infections
Patients and doctors may be familiar with other milder species of Candida that cause common vaginal and skin infections, such as yeast infections, according to the CDC. The antifungal medications commonly used to treat these Candida infections typically don’t work for C. auris, says Sexton. While this superbug version of Candida can live on the skin and not cause an infection or any symptoms, it can still bring severe illness to those who are vulnerable. The most common signs are fever and chills, but these symptoms can be confused with other illnesses. The only definitive way to diagnose a C. auris infection is through a laboratory test. The number of cases may be rising, but they are still relatively few at this point, and almost all cases remain confined to healthcare settings such as hospitals and nursing homes. “Still, C. auris presents a public health concern because of its ability to cause large and persistent outbreaks,” says Sexton.
