Health Advisory: Candida auris Reported in Two Washington Counties

This is a health advisory from the Washington State Department of Health (DOH) Office of Communicable Disease Epidemiology Healthcare Associated Infections and Antimicrobial Resistance Section.

Actions Requested 

Be aware that several locally acquired cases of Candida auris (C. auris) have been recently identified in two Washington counties.

  • A King County long-term acute care hospital has identified an outbreak involving 3 patients colonized with C. auris.
  • A Snohomish County skilled nursing facility has identified a single patient colonized with C. auris.
  • No deaths in Washington attributed to C. auris have been reported. The Washington State Department of Health (DOH) and the two local health jurisdictions (LHJ) are working with the impacted facilities to ensure that appropriate infection control precautions are in place and to screen additional patients.
  • See PHSKC health advisories and Public Health Insider for details about this situation provided by Public Health – Seattle and King County (PHSKC).

Public Health recommends that facilities screen for C. auris patients who are currently admitted and had a prior admission at Kindred Hospital Seattle – First Hill since October 1, 2023.

  • Out of an abundance of caution, healthcare facilities can consider screening more broadly as resources allow to include patients with a stay at Kindred since June 1, 2023.
  • Public health will notify LHJs of any patients discharged from Kindred and transferred directly to another healthcare facility in their jurisdiction.

Be aware that DOH provides free C. auris screening for certain patients.

  • Facilities should contact their LHJ to receive further guidance.

DOH recommends that ventilator capable skilled nursing facilities in Washington screen their current patients for C. auris using DOH-provided free testing.

Other healthcare facilities should identify high-risk exposures in newly admitted patients and consider C. auris screening for those who have had:

  • Close contact in a healthcare setting to someone diagnosed with C. auris or a carbapenemase-producing organism (CPO) infection or colonization. Close contact may include:
    • Sharing a room, bathroom, or patient care equipment
    • Being cared for by the same healthcare staff
    • Staying in a room near a person with C. auris or CPO
  • Direct admission from a ventilator-capable skilled nursing facility or a long-term acute care hospital
  • Colonization or infection with a CPO
  • An overnight stay in the prior year in a healthcare facility:
    • Outside the U.S., or
    • In a region of the U.S. with a high burden of C. auris cases

Be aware that C. auris can be misidentified through commercial laboratory testing and specific technology is needed for correct identification.

Report to public health within 24 hours any suspected or confirmed C. auris cases or outbreaks.

Current Situation in Washington

On 1/22/2024, an outbreak involving 3 patients colonized with C. auris was reported in a long-term acute care hospital in King County. On 1/26/2024, an additional patient colonized with C. auris was reported in a skilled nursing facility in Snohomish County. One other locally acquired C. auris colonized patient was reported in July 2023. In addition to these patients, public health is aware of 5 other patients who acquired their C. auris colonization outside of Washington and have since received healthcare in Washington.

C. auris is an emerging fungus that was first reported in 2009 in Japan and has spread globally. It is a life-threatening, highly transmissible, often multidrug resistant yeast that can cause difficult to control healthcare outbreaks among vulnerable patients. Based on information from a limited number of patients, more than 1 in 3 people with C. auris infections have died. Patients needing long term acute care and indwelling medical devices are at the highest risk for acquisition, and once colonized, for infection.

Since 2022, DOH has provided free screening to certain patients who are at higher risk for C. auris and other highly antibiotic resistant organisms through the Partners for Patient Safety Program. The locally acquired C. auris cases in Washington have been identified through this program. DOH released a prior health advisory in July 2023 (PDF) with C. auris infection prevention guidance.

Resources

Contact

For questions, or to report cases, please contact: your Local Health Jurisdiction or MDRO-AR@doh.wa.gov.