Three cases of deadly, pan-resistant C. auris identified in NYC

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Three cases of patients with pan-resistant Candida auris infections, that is, resistant to all three classes of commonly prescribed antifungal drugs, have been identified in New York City, the CDC reports.

C. auris, a deadly fungus, was first identified in the U.S. in 2016. As of Oct. 31, 2019, there were 911 confirmed clinical cases of C. auris in the country, of which 427, the largest by far, are in New York.

As of June 28, 2019, there were 801 patients colonized with C. auris detected in New York, which means they were asymptomatic and identified through the use of clinical cultures or skin or nose screening swabs only. A vast majority of the cases were resistant to one of three classes of common antifungal medications: flucanazole, amphotericin B, and echinocandins. But samples taken from three patients were resistant to all three classes.

All three patients with pan-resistant C. auris infections were older than 50 years and developed the infections in 2017 and 2018. Two were residents of long-term care facilities in the same New York borough, while the third had prolonged hospital and long-term care facility stays in a different borough. All three patients died. The third patient in the separate borough died from underlying conditions of the infection, but the role C. auris played in the deaths of the first two patients is unclear.

CDC researchers and state health officials said that these findings highlight the need to continue surveillance for C. auris as well as encourage the judicious use of antifungal drugs. They also urge continued susceptibility testing, which is used to determine which antibiotics will be effective against bacteria or fungi causing an infection.

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