Fungi are everywhere —that moldy loaf of bread you forgot was sitting on your counter, the athlete’s foot you got last summer, and even the microscopic fungi that sneakily hide in your microbiome. According to the Centers for Disease Control and Prevention (CDC), there are millions of fungus types, but only a few hundred can make people sick. In March of 2023, the CDC highlighted the threat of a rapidly increasing fungus (Candida auris) that is causing infections and deaths in hospitals across the country. This newly discovered fungus is only part of a larger increase in fungal infections across the U.S.
Mild fungal infections are common.
Fungal infections like ringworm, athlete’s foot, and vaginal yeast infection are extremely commonplace and can usually be treated with antibiotics, topical ointments, or other methods. These infections are usually milder and do not pose much of a threat to the human body at all.
Candida auris, however, can cause infections within the body that are much more dangerous and require immediate medical attention. A type of yeast first identified in 2009, Candida auris is much more resistant to antibiotics than its counterparts, causing some reason for concern in the medical community.
Candida Auris by the Numbers
With the increased stress placed on hospitals due to the COVID-19 pandemic causing inconsistent sanitation practices and the enhanced number of sick patients in these hospitals, the number of clinical cases of Candida auris has increased from 44% in 2019 to 95% in 2021.
Recent CDC data suggests that Nevada, California, Florida, New York, Illinois, and Texas have had well over 100 clinical cases from January to December 2022. The number of deaths from Candida fungi has also increased from 1,010 in 2018 to nearly 1,800 in 2021.
What can healthcare professionals do?
The CDC recommends taking several infection control measures to prevent the spread of Candida auris, including hand hygiene, disinfecting the patient environment, and screening for new cases.
Additionally, it is important to communicate with your patients about potential risk factors for fungal infection. Fungal infection symptoms can be similar to many conditions or illnesses. This makes it challenging to get an accurate diagnosis and prompt treatment. Here are some common questions you can ask your patients to determine their risk of fungal infection:
- Have you recently been sick? You are at higher risk of infections if you have a weakened immune system from radiation treatment, chemotherapy, organ transplants, or lung infections. Fungal infections can target almost any part of the body.
- Where do you live and travel? Disease-causing fungi are common in specific regions of the world.
- What types of activities are you doing? Harmful fungi can travel through the air, dust, and soil. If you partake in activities like digging, gardening, cleaning chicken coops, and visiting caves, you could inhale harmful fungi.
- Have you recently taken antibiotics? Antibiotics do not work for fungal infections. Because they often have the same symptoms as bacterial infections, misdiagnosis is common, and doctors often prescribe antibiotics. According to the CDC, some antibiotics increase fungal infections. In hospital settings, patients who take antibiotics for a wide range of bacterial infections are at higher risk for Candida auris and Candidemia.
- Are you taking medications or treatments that weaken your immune system? Some steroids (corticosteroids) and tumor necrosis factor (TNF) inhibitors put your body at a higher risk of fungal infection. The longer the use of steroids, the more likely a fungal infection can occur.
- Do you use communal showers or locker rooms or share linens or towels? Ringworms can live on your skin, surfaces, or household items like towels or bedding. Do not walk barefoot in communal showers or locker rooms; do not share clothing, towels, or sheets; and keep your skin clean and dry.
- Are you staying in a healthcare facility (long-term care, hospital, or skilled nursing home facility?) In the U.S., one of the most common bloodstream infections contracted at the hospital is caused by Candida. While common and harmless in the gastrointestinal tract, it can enter the bloodstream and cause infection. Candida auris is often resistant to antifungals and can spread more easily between patients in healthcare settings.
Fungi are all so different, making it hard to narrow down symptoms.
There are several different types of fungal infections that target several different parts of the body. It is impossible to generalize symptoms because it all depends on which part of the body is affected, the seriousness of the infection, and whether the patient already has a weakened immune system.
A common fungal infection may present a rash or itchy skin. When fungi enter the bloodstream and cause meningitis, the symptoms include fever, headache, stiff neck, nausea, light sensitivity, and confusion. This can be fatal without treatment. Fungal infections in the lungs can produce chest pain, difficulty breathing, cough, and fatigue.
Stressing good hygiene, cleaning your patient environment, and keeping abreast of symptoms, warning signs, and risk factors can all aid in recommending effective treatments for patients with fungal infections.
For more information about specific types of fungal infections, visit the CDC website.
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