Cedars-Sinai Blog

What Is Candida Auris?

An illustration of Candida auris.

When we're sick, we take targeted medications to kill infectious germs. But increasingly more pathogens are becoming resistant to established treatments such as antibiotics.

Multi-drug resistant organisms—otherwise known as superbugs—have evolved to learn to evade our best defenses. In California, superbugs cause about 360,000 illnesses and nearly 4,500 deaths every year.

"If C. auris becomes resistant to the three main classes of antifungals, treatment of the infection becomes very challenging,"

Lena J. Heung, MD, PhD

Lena J. Heung, MD, PhD

One emerging fungus with the potential to become a superbug, Candida auris, caused an outbreak of infections throughout Southern California healthcare facilities over the summer. At Cedars-Sinai, rigorous attention to infection control, as well as innovative approaches to avoid antibiotic overuse, helps combat such superbugs. We asked Dr. Lena Heung, an infectious disease expert studying new ways to fight drug-resistant fungi, to explain what we know.

What is C. auris?

C. auris is a fungus that was identified only about 10 years ago. It is not completely understood where it originated, but it is part of the Candida family—these types of yeasts live normally on our skin along with other microbes. 

The Centers for Disease Control and Prevention has recently classified C. auris as an urgent threat because it spreads easily and can be resistant to treatment. Most cases of C. auris in the U.S. are treatable with two of the three main classes of antifungals, but some have been found to be resistant to all drugs, Dr. Heung says.

The fungus is able to "stick" to surfaces and survive for a long time, and then spread through a person's skin contact with a surface, or through person-to-person contact. It can enter through the skin into the bloodstream and cause infection. C. auris can cause infections to wounds, the bloodstream and ears—and can be detected with a culture of the affected area.

Who is most at risk for C. auris?

People who are at risk for being infected by C. auris are patients who have recently undergone surgery, people with feeding tubes or catheters, people with diabetes or those who take broad-spectrum antibiotic and antifungal medications. It's most dangerous in long-term care facilities, such as nursing homes, which are taking aggressive measures—in conjunction with public health agencies—in identifying and isolating people who are infected or colonized, Dr. Heung says. 

In general, fungi become dangerous, and cause disease, when there is a disruption in the balance of the body's microbial population that allows one type to overgrow. Overuse of antibiotics can cause such disruption to the body's microbial community.

"For an everyday healthy person, antibiotics could cause an imbalance in microbiota and make a person more susceptible to a vaginal yeast infection—which is on the less severe spectrum, and can be fixed with straightforward treatment," Dr. Heung says. "But on the more severe end, for a more immunocompromised patient, an infection could require more invasive interventions."

What are scientists doing?

Scientists are vigilantly monitoring for new cases of C. auris, and actively studying experimental antifungals and drug combinations to fight the fungus.

"If C. auris becomes resistant to the three main classes of antifungals, treatment of the infection becomes very challenging," Dr. Heung says. "Until we have results from systematic studies on C. auris, we have to use our best judgment as to what drug combinations might be helpful."

What should people know about the spread of C. auris?

Dr. Heung says people should continue to adhere to common pandemic procedures by practicing good hand hygiene.

Also, patients should only use antibiotics responsibly and appropriately when prescribed by a physician. Work with your doctor to determine when you actually need antibiotics to control an infection.

"An ongoing concern is that fungi and other microbes will develop resistance to currently available drugs at a rate that outpaces our ability to develop new therapies," she says. "One way to mitigate the spread of such bugs is responsible use of antifungals and antibacterial drugs."