Experts are warning about a multi-drug resistant fungus known as a “superbug,” which has been detected in Connecticut.
Candida auris, called a “superbug” due to its resistance to treatment, was first discovered in 2009, and the first clinical cases began appearing in 2016, according to the Centers for Disease Control.
In 2023, there were 4,514 new clinical cases in the United States, and the number continues to increase.
In Connecticut, there have been eight confirmed cases of Candida auris since 2017, according to CDC data. The state Department of Public Health began testing for the fungus in 2017, as cases started to grow across the country.
What makes Candida auris dangerous is its ability to withstand most common disinfectants, its resistance to most drugs and ability to rapidly spread, according to Dr. Scott Roberts, an infectious disease specialist at Yale New Haven Health and Yale New Haven Hospital.
“There are three main problems with Candida auris that we don’t see with other Candida species, first is its resistance to antifungals. There are three main classes of anti-fugal drugs and the problem with Candida auris is there have been some islets out there that are fully drug resistant to all three,” Roberts said.
“That’s not seen with other yeast candida species. The second problem is it causes outbreaks. This has been clearly linked to outbreaks in nursing homes and hospitals. The third problem is a lot of places can’t identify it because it’s so new. It came about in the early 2000s and never really got reported that well.”
Candida, a genus of yeasts, is the most common cause of fungal infections worldwide, according to Roberts. The genus Candida encompasses about 200 different species. Candida is often responsible for most yeast infections with the majority of species reactive to treatment. Candida auris is one of the few yeast species that has become resistant to several drugs.
“It’s been documented around New York City for over a decade,” Roberts said. “So when it comes to New York, Connecticut is not far behind. I think we’re starting to see that with a slight uptick in cases.
“But it’s not like you’re going to get Candida auris at the grocery store. This is not a bacteria or virus and doesn’t spread through coughing or sneezing,” Roberts said. “This is really something that impacts vented nursing facilities or immunocompromised individuals in long-term health facilities.”
People without risk factors generally do not get infected or colonized with Candida auris infection, Roberts said. Candida auris mostly affects patients with severe underlying medical conditions who require complex medical care. Patients with invasive medical devices like breathing tubes, feeding tubes, and catheters are at increased risk for infection.
“We don’t see it in otherwise healthy people, if someone with a healthy immune system got Candida auris it would most likely clear up,” Roberts said. “Unless someone is a high risk person who is exposed to a long-term health care facility, it’s not something to really worry about. But it is a concerning problem in nursing homes and hospitals for patients with weakened immune systems.”
According to Roberts, on occasion, health care providers give patients antibiotics or anti-fungals if they have a weakened immune system or right before or after surgery. However, antibiotics and anti-fungals should be used carefully and stopped when no longer needed. Taking these medications for a long time impacts the body’s natural abilities to protect itself and can increase the risk for Candida auris infection or colonization.
“Candida auris is definitely something we are seeing being spread within the health care community,” said Dr. Ulysses Wu, an infectious disease specialist with Hartford HealthCare.
“It is in Connecticut and in most major hospitals. It’s not necessarily new, but its resistance to treatment options is what makes it scary,” Wu said. “When patients do get Candida auris, we have to take precautions including wearing a gown and gloves. Sometimes, in nursing homes and health care settings, it can spread easily and cause outbreaks.”
Hartford HealthCare
Dr. Ulysses Wu, chief epidemiologist at Hartford HealthCare
Candida auris can spread easily from patients who are colonized or infected through physical touch, Wu said. Health care providers can help stop it from spreading by frequently using alcohol-based hand sanitizer or soap and water to wash hands and using disinfectant to clean surfaces. While some disinfectants don’t work on Candida auris, bleach has shown the ability to kill the yeast, according to the CDC.
“Staff training and hand hygiene is very important,” Wu said. “The problem is Candida auris can persist on surfaces in health care settings and has already been cultured from multiple locations in a patient room.
“Not necessarily all disinfectants will work to kill the yeast,” he said. “So a standard cleaning may not be effective. There are certain products that work to kill Candida auris. So it’s important health care facilities have protocols in place.”
Stephen Underwood can be reached at sunderwood@courant.com.