QUESTIONS AND ANSWERS

Question: Did my healthcare team track my Candida risk factors?

Answer: It depends. You may be diagnosed with invasive candidiasis by a healthcare provider who does not specialize in infectious diseases. Not all providers are knowledgeable about invasive candidiasis. According to Dr Vazquez, many providers outside of infectious diseases and hematology/oncology have limited experience with invasive candidiasis. They have not had a lot of training on the topic. That’s why a consultation with a specialist in infectious diseases is important.

Question: If I am at really high risk for invasive candidiasis, can I take medicine to prevent it?

Answer: Yes, some patients with a high risk of invasive candidiasis can receive antifungals prophylactically to prevent invasive candidiasis. Such patients include:

• Organ transplant recipients
• Patients in the intensive care unit who are high risk
• Patients with low neutrophil counts (neutropenia) caused by chemotherapy
• People who have received a stem cell transplant and have neutropenia

Question: What specific symptoms are associated with invasive candidiasis? Does invasive candidiasis look different than a bacterial infection?

Answer: The symptoms of invasive candidiasis are often non-specific. Patients often have fever and chills, which bacterial infections also cause. It is not easy to tell these types of infection apart based on symptoms. But if a patient has fever or chills that do not respond to antibacterial treatment, that’s a good time to think about invasive candidiasis. Also, when invasive candidiasis affects different organs, it can cause symptoms associated with the heart, gut, bones, joints, brain, and eyes.

Question: What can patients and families do to prevent C. auris infections?

Answer: Patients and families can take several important steps to help prevent drug-resistant infections like C. auris. According to CDC, make sure to:

• Tell your doctor if you have ever been diagnosed with C. auris or another drug-resistant infection, or hospitalized elsewhere, especially outside of the United States.
• Take antifungals and antibiotics only as prescribed.
• Expect all healthcare personnel to wash their hands with soap and water or an alcohol-based hand rub before and after touching your body or tubes going into your body. If they do not, ask them to do so.
• In many healthcare settings, healthcare personnel will wear gloves and gowns when interacting with patients with C. auris.

Persons with a history of C. auris infection or colonization who are living at home do not need to isolate or take other special precautions in the community. If you have C. auris or are caring for someone who does, make sure to clean your own hands and practice good hygiene. This is especially important during the following activities:

• Before preparing or eating food
• After using the bathroom
• Before and after changing wound dressings or bandages
• After blowing your nose, coughing, or sneezing

Question: I am a healthy 45-year-old woman married to a 50-year-old man who was infected with C. auris. He carries C. auris on his skin (he is colonized) but is no longer sick. Do I need to get checked for C. auris? 

Answer: That’s an excellent question. Healthy individuals generally do not need to be screened for C. auris, even if they are caring for an infected or colonized patient. However, you should wash your hands frequently with soap and water or an alcohol-based hand sanitizer after interacting with your husband. If you are providing care for your husband, for example, changing his wound dressing or helping him bathe, you should consider wearing gloves. If your husband has any kind of invasive medical devices, you should also be extra careful to help prevent C. auris on the skin from getting into his body.

Question: I have a loved one who has been in and out of long-term acute care facilities. Should I be concerned about my loved one being infected with C. auris?

Answer: Yes, a patient who has been in and out of high-risk facilities has an increased risk of exposure. Right now, the Centers for Disease Control and Prevention (CDC) recommends that patients get screened for C. auris who:

• Have a link to a patient with auris (were in the same facility, had shared healthcare personnel, or were exposed to common portable medical equipment)
• Were at a high-risk facility (facilities with a current suspected auris transmission, a long-term acute care hospital, a ventilator-capable skilled nursing facility, or a facility outside the United States or a part of the United States with a lot of C. auris)
• Have risk factors for acquiring auris (breathing tube, indwelling medical devices, receipt of complex or high acuity care, or colonization or infection with other multidrug-resistant organisms)