That PSA has been up for months in the department. And yet, I still have not come across a culture with possible Candida auris. For those of you who are unfamiliar with the organism, it is one of the latest worries under the CDC watchful eyes. Why? Because this yeast is resistant to multiple drugs used in fungal infections. On top of that, it is not too difficult to misidentify it.
A brief history shows that it was first described in 2009 and caught attention in the medical field in 2016. For more general information, please visit the CDC's page:
In essence, it's like any other Candida infection, but deadlier. From the CDC's general information, it would appear to be a nosocomial infection. When you combine multi-drug resistance and immunocpromised patients, bad things happen. It is a practical death sentence.
As a laboratory professional, I am told that it is easy to misidentify this organism. Here's a chart from the CDC website:
From that, I can understand why Candida haemulonii appeared on the PSA. It is actually the closest related species to our culprit. As for the name Candida parapsilosis, it is not an uncommon find at work, but it does make you wonder if it's C. auris. The good news is, I have not seen the pink yeast colonies on CHROMagar described on the website.
So, what is the most reliable identification method according to the medical authorities? It turns out the MALDI-TOF is our best friend in this case. For a while, I thought that our department might have been missing C. auris infections.
Our lab uses the Bruker Biotyper. Since this year's switch to the BD Kiestra automation, all our software, hardware, etc. had to be up to date. Part of me feel more secure knowing that we are using the latest technology in healthcare.
The real question is, has there been any cases of Candida auris infection in Utah? Well, as of March of this year (2019), there was no reported cases according to the State.
Does that mean it won't happen? I don't know and I doubt it. Should you worry about this particular organism? Most likely because the nature of this beast seems closer to opportunistic infections.
It will be interesting to see if new drugs and treatments will come about to combat this rising killer.