Emerging Fungal Infection Spreading At Alarming Rate: See NJ Data

NEW JERSEY — A drug-resistant, potentially deadly fungus has been spreading at a troubling rate in U.S. health care facilities, including some in New Jersey, according to a new government study.

A Centers for Disease Control and Prevention study, published in the Annals of Internal Medicine, found the number of cases of the fungus Candida auris, or C. auris, “spread at an alarming rate” from 2020 to 2021. Equally troubling, the agency said in a news release Monday, is that the number of cases resistant to a commonly prescribed antifungal medicine more than tripled.

According to the CDC, C. auris is an "emerging fungus that presents a serious global health threat."

The fungus is found normally throughout the body and on the skin. It’s not a threat to healthy people, but for people with serious medical conditions that land them in the hospital or other health care facilities, infections can be deadly. C. auris kills about one-third of people who contract it.

CDC data shows 94 clinical cases of C. auris have been reported in New Jersey in 2022, the most recent 12 months for which data is available. That’s up from 78 cases reported in 2021 or 49 cases in 2017.

The New Jersey Department of Health issued the following statement to Patch in regards to this spread:

"As an emerging antimicrobial organism that is difficult to treat and often strikes the most medically vulnerable, the state Health Department takes Candida auris very seriously. We continue to encourage healthcare facilities to practice appropriate infection control, to remain vigilant for introduction into their facilities, and to work with public health should cases arise.

The Department responds to all reports of C. auris in New Jersey and supports prevention efforts through surveillance testing and infection prevention recommendations. NJ does conduct surveillance for both clinical infections and colonization cases to prevent future spread in vulnerable populations across all healthcare setting types. The number of infections for C. auris can be viewed at the Centers for Disease Control and Prevention. Note: this information is only provided from healthcare facilities, not community-based or outpatient settings, and is also voluntarily reported to CDC which means these numbers likely do not represent all cases.

In September 2021, the Department communicated the need for heightened awareness and focus on appropriate infection prevention and control measures, which are critical to prevent spread (https://www.nj.gov/health/cd/documents/topics/hai/Cauris_regional_increase.pdf). As part of the ongoing focus, the Department issued grants in December to train healthcare personnel in NJ about infection prevention, including on C. auris."

The CDC said poor general infection and control practices in health care facilities are a likely cause of the spread, though increased screening may also explain the increase. The agency said the timing of the increase is also likely tied to the strain put on health care facilities during the COVID-19 pandemic.

“The rapid rise and geographic spread of cases is concerning and emphasizes the need for continuing surveillance, expanded lab capacity, quicker diagnostic tests, and adherence to proven infection prevention and control,” CDC epidemiologist Dr. Meghan Lyman, the lead author of the paper, said in the news release.

The first U.S. case of C. auris was reported in 2016. Since then, 3,270 clinical cases in which an infection was present and 7,413 screening cases confirming the fungus but not an infection had been reported by Dec. 31, 2021.

Clinical cases have increased every year, but the most rapid rise was from 2020-2021, when 17 states identified their first-ever cases of C. auris, according to the CDC.

Nationwide, clinical cases rose from 476 in 2019 to 1,471 in 2021. Screening cases tripled from 2020 to 2021, for a total of 4,041. Screening is important to prevent spread by identifying patients carrying the fungus so that infection prevention controls can be used, according to the CDC.