Increasing Emergence of Candida auris (SNF)

The Michigan Department of Health and Human Services (MDHHS) is alerting healthcare providers of the increasing emergence of Candida auris (C. auris) cases in Southeast Michigan, linked to acute care hospitals (ACH), Long-Term Acute Care (LTAC) Facilities, and Skilled Nursing Facilities (SNF). Michigan has reported 15 cases since May 2021, 13 of those detected in the last 4 months.

The C. auris patients detected in Michigan have moved frequently across the continuum of care. Ninety-three percent of the cases had ACH exposure in the 90 days prior, 53% reported LTAC exposure, and 25% SNF exposure. The presence of indwelling devices has been high with mechanical ventilation (73%), percutaneous gastrostomy tube (60%), tracheostomy (53%), and central venous catheter (40%) reported. Most cases have been detected via colonization screen/axilla-groin (53%), followed by urine (20%), wound (7%), respiratory (7%), other (7%) and blood (6%).

Detection by laboratories who have been speciating yeasts from non-sterile sites of high-risk patients have been instrumental in finding some of these early cases. Speciation of yeasts from only sterile sites will likely be insufficient for detecting and preventing spread of this pathogen.

C. auris containment continues to be an urgent public health priority. Patients and residents who have had prolonged admission in healthcare settings, high-acuity long-term care facilities including LTACs and ventilator skilled nursing facilities (vSNF), are at highest risk of C. auris and other multidrug-resistant organism (MDRO) colonization and infection. Additionally, epidemiological data from recent C. auris cases suggests that patients with long-term admissions in high-acuity ACH units (e.g., ICU and step-down units) can be at an increased risk for C. auris acquisition.

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