Candida auris

What is Candida auris?

Candida is a group of fungi (yeasts) that live on the skin and inside the human body. Candida auris, or C.auris, was first reported in 2009 and has spread quickly to many countries across the world. Currently, C. auris is still uncommon in Australia.

C.auris is a concern because it:

• can cause serious infections such as bloodstream and wound infections
• is difficult to treat as some of the medications usually used are no longer effective
• is hard to identify in the laboratory
• spreads easily between patients in hospitals and nursing homes (known as healthcare facilities).

How do you get Candida auris?

In Australia, most cases of C.auris have been found in patients who have been exposed to the fungus in an overseas hospital. These people can carry the fungus on their body without it causing any symptoms or an infection. This is called colonisation. In people who are very sick, such as those in intensive care units or those with a weak immune system, it may cause serious infections. These people are said to be infected.

C.auris can spread person-to person through contact with someone who is colonised or infected and also via shared equipment that has not been adequately cleaned or disinfected. C.auris can survive on surfaces for long periods, so inadequate cleaning of the environment is another way it can spread. C. auris cannot be caught through coughing or sneezing or through breathing it in the air.

What are healthcare facilities doing to prevent spread?

Infection prevention and control (IPC) measures are actions taken at healthcare facilities to prevent or stop diseases from spreading. Healthcare facilities use the same IPC measures for patients colonised or infected to help prevent spread of C.auris to others. If you are colonised or infected with C. auris, you will still receive the same level of care in hospital.

Healthcare providers can help stop C. auris from spreading with these actions:

• performing frequent handwashing or use an alcohol-based hand rub when providing care to you
• a sign will be placed on your door to remind others of the precautions they need to follow, for example, to wear a gown and gloves when providing care
• being cared for in a single room with your own bathroom
• frequent cleaning and disinfection of your room, bathroom and medical equipment
• ensuring visitors clean their hands with alcohol-based hand rub or soap and water. In addition, visitors should avoid using your bathroom or visit other patients or residents immediately after visiting you.

Patients infected or colonised with C. auris may often have it on their skin or other body sites for a long time. Precautions are taken until they are discharged.

For patients living in settings like nursing homes, long-term measures are taken based on the facility's policy.

Screening

Screening patients for C. auris is an important way to prevent or stop outbreaks in healthcare facilities and keep patients safe. Patients who are colonised with C. auris may not know it because they do not have any symptoms.

All patients on admission to a Western Australian (WA) hospital will be asked if they have been in a hospital outside of Australia in the past year. If the answer is ‘Yes’, then the healthcare provider will organise to collect samples for testing. This involves wiping a cotton swab over the skin in the armpits and  groin, these are  the body sites where C.auris is often found.

Notification

C.auris is a notifiable condition in WA. This means healthcare providers and laboratories must inform the Department of Health of your C.auris positive result. Notification is confidential.

If you test positive for C.auris, an alert will be placed in your medical record to let your healthcare provider know you have C. auris. This alert can be seen in all public hospitals in WA. Should you go to a private hospital, or another healthcare provider e.g. your local doctor, you need to tell them you have C.auris. There is no need to tell other community services or businesses that are not healthcare services e.g. swimming pools, gyms or schools that you have C. auris.

Can Candida auris be treated?

People colonised with C.auris do not need to have any treatment or antifungals drugs.

C.auris infections can be treated with antifungal drugs, however, some C.auris have become resistant (this means some medications are no longer effective), to the three main types of antifungal drugs, making them more difficult to treat. Your doctor may have to use multiple antifungal drugs at high doses to treat severe infections. Your doctor will talk to you about the treatment you may require.

There is no vaccination available to prevent you from acquiring C.auris or treatment to eliminate C.auris from your body.

What will happen when I go home?

There is no need to take special precautions at home, but it is important that you and your family continue to practice good hygiene including:

• always washing your hands with soap and water
  • after going to the toilet
  • before preparing or eating food
  • before and after touching any wounds or medical devices that you may have.
• using your own towels and face cloths. Do not share these items with other people.

No special cleaning is required in your home and your clothing may be laundered as usual, along with the rest of the household laundry. All eating utensils and dishes can be washed in the normal way. You can return to work.

More information

• If you are in hospital, you can ask to speak to the infection prevention control nurse.
• See your doctor.
• Ring healthdirect Australia on 1800 022 222.

Remember

• Candida auris is very uncommon in Australia.
• Candida auris is resistant to many antifungal medications.
• Candida auris can spread from person to person through contact with infected or colonised people.
• Hand hygiene is a simple but very effective measure that stops the spread of germs.
• Remember to tell your healthcare provider you have Candida auris.

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This publication is provided for education and information purposes only. It is not a substitute for professional medical care. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional. Readers should note that over time currency and completeness of the information may change. All users should seek advice from a qualified healthcare professional for a diagnosis and answers to their medical questions.