Notes from the Field: Transmission of Pan-Resistant and Echinocandin-Resistant Candida auris in Health Care Facilities ― Texas and the District of Columbia, January–April 2021

摘要

Candida auris is an emerging, often multidrug-resistant yeast that is highly transmissible, resulting in health care–associated outbreaks, especially in long-term care facilities. Skin colonization with C. auris allows spread and leads to invasive infections, including bloodstream infections, in 5%–10% of colonized patients ( 1 ). Three major classes of antifungal medications exist for treating invasive infections: azoles (e.g., fluconazole), polyenes (e.g., amphotericin B), and echinocandins. Approximately 85% of C. auris isolates in the United States are resistant to azoles, 33% to amphotericin B, and 1% to echinocandins ( 2 ), based on tentative susceptibility breakpoints. * Echinocandins are thus critical for treatment of C. auris infections and are recommended as first-line therapy for most invasive Candida infections ( 3 ). Echinocandin resistance is a concerning clinical and public health threat, particularly when coupled with resistance to azole and amphotericin B (pan-resistance).