Candida auris identified in Oregon

Actions requested

• Be aware that Candida auris was recently detected in a patient in Oregon, with subsequent healthcare-associated transmission to other patients.
• Be aware of growing concerns for multidrug-resistant C. auris infections in the U.S.
• Consultation with an ID specialist and Public Health – Seattle and King County is highly recommended when C. auris colonization or infection is suspected to ensure appropriate testing and treatment.
• Consider C. auris screening in patients at high risk for C. auris, including those who had:
• Close contact in a healthcare setting to someone diagnosed with C. auris infection or colonization
• An overnight stay in a healthcare facility outside the U.S. or in a region within the U.S. with documented C. auris cases in the previous year.
• Inquire about the above high risk exposures in all newly admitted patients.
• Coordinate C. auris screening and testing with Public Health at (206) 296-4774.
• Be aware that C. auris can be misidentified through laboratory testing as a number of different organisms and specific technology is needed.
• Remain vigilant for any increase in infections due to unidentified Candida species in a patient care unit, including from urine specimens, and consider C. auris since it can be transmitted in healthcare settings.
• Patients in hospitals with suspected or confirmed C. auris should be managed using contact precautions, and placed in a single room whenever possible.
• Reinforce and audit core infection prevention practices in healthcare facilities.
• Communicate information about colonization or infection with C. auris during care transitions within and transfers between healthcare settings. CDC Interfacility transfer form
• Please immediately report any suspected or confirmed C. auris cases or outbreaks to Public Health at (206) 296-4774.

Background

Since its discovery in 2009, C. aurishas emerged globally as a life-threatening, highly transmissible, often multidrug resistant yeast. In the past year CDC has published several reports of ongoing transmission of highly resistant strains of C. auris in United States healthcare facilities, particularly in units caring for patients recovering from COVID-19 1,2,3 Patients with long term acute care and indwelling devices are at highest risk for acquisition. International healthcare is often the initial source of introduction of C. auris to a region. Subsequent healthcare transmission may occur due to shedding in the healthcare environment, resistance of C. auris to standard healthcare disinfectants, and lapses in infection control practices.

C. auris has not yet been detected in Washington but represents a serious threat. For details about where cases have been identified within the U.S., see the map. WA DOH performs special surveillance for C. auris by screening isolates submitted from high risk patients and sentinel lab submissions of non-albicans Candida species to the WA Public Health Laboratory for identification.

C. auris will become a notifiable condition in WA as of January 1, 2023. In the meantime, we consider C. auris to be reportable immediately to Public Health as a 'rare condition of public health significance.' All suspected HAI outbreaks (which includes a single case of C. auris in a healthcare facility) are also required to be reported immediately to Public Health.