Rapid Increase in Candida auris Infections in Florida Health System

A March 19 news brief from CIDRAP stated that “a retrospective study conducted at a large health system in Florida found that the volume and complexity of infections caused by Candida auris have rapidly increased over the last few years, researchers reported this week in the American Journal of Infection Control.”

Further, “In the study, researchers at Jackson Health System in Miami, which reported its first C auris case in 2019, identified 327 clinical cultures of the multidrug-resistant fungus in 231 patients from April 2019 through December 2023. The number of C auris–positive clinical cultures increased each year, rising from 5 in 2019 to 115 in 2023. Expressed as rates per 100,000 patients, this represented an increase from 4.0 positive cultures in 2019 to 28.0 in 2023—or a sevenfold increase. Hospital-onset and community-onset infections accounted 79.5% and 21.5% of cases, respectively.”

Additionally, the news brief explained that blood cultures positive for C auris increased from 2019 through 2021 and remained the main source throughout the study period. Yet, the percentage of C auris–positive blood cultures declined and stabilized in 2022 and 2023. Jackson Health System in Miami saw a substantial increase in specimens from soft-tissue and bone infections in 2022 and 2023.

“Phylogenetic analysis of 13 samples showed that all isolates belonged to clade 3, the South African clade,” the brief added. “Antifungal susceptibility testing showed all isolates were resistant to fluconazole and susceptible to micafungin and amphotericin B.”

The study found that the increase in the amount of C auris–positive clinical cultures is on par with U.S. national trends. CDC data shows the annual number of clinical C auris cases has risen from 51 in 2016 to 4,514 in 2024.

The authors of the study are particularly concerned about the increase in bone and soft-tissue infections due to these infections needing wound care, leading to an increase in the burden of C auris environmental contamination in the hospital and putting others at risk.