What are the long-term risks of Candida auris colonization?

Question

Hello doctor,

I am a nurse at a long-term care facility and just tested positive for Candida auris after exposure to a patient. The infection control team told us it is resistant to almost everything. I have no symptoms yet, but my supervisor says I cannot work for at least 14 days. My screening test showed colonization on my skin, particularly under my nails and between my toes. What should I do to prevent spreading it to my family?

My husband is on immunosuppressants for rheumatoid arthritis, and I am terrified I will give it to him. Is there preventative treatment? Should everyone in my household get tested? The facility had three residents die from Candida auris infections in the past month. I am obsessively washing with Chlorhexidine, but I am worried it might not be enough. What long-term risks do I face if I am colonized?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

To prevent the spread to family members, you should follow proper hygiene practices, including thorough handwashing with soap and water or using an alcohol-based hand sanitizer (for example, ethyl alcohol or isopropyl alcohol) before and after contact with the nurse or objects potentially touched by the nurse. Additionally, the nurse should use her items, such as towels and razors, and family members should disinfect surfaces and objects in the household. Family members should also wash their hands with soap and water or use an alcohol-based hand sanitizer, especially before and after contact with the nurse, potentially contaminated surfaces, or personal items.

Consider wearing disposable gloves when providing close-contact care, such as wound care or bathing, and practice hand hygiene after removing gloves. Clean and disinfect the nurse's living space using a solution of bleach and water (one part sodium hypochlorite [Clorox] to nine parts water) or a disinfectant recommended by the healthcare facility. Inform healthcare providers about the nurse's Candida auris status when seeking medical care for themselves or the nurse.

Follow instructions from healthcare providers on proper care for the nurse if she is being cared for at home. While the risk of Candida auris infection in otherwise healthy individuals is low, it is still important to practice good hygiene and infection control measures. Therefore, your husband also needs to be careful and maintain all necessary precautions. Family members of healthcare workers do not typically need to be tested for Candida auris, unless they are at high risk due to their health status. Since your husband is immunocompromised, he must be screened for the organism, but other healthy household members do not need to be tested unless they develop symptoms.

Isolate yourself from other family members if possible for the time being. While not all colonized individuals develop infections, the long-term risk of colonization with Candida auris poses a significant threat to both healthcare workers and patients, particularly in healthcare settings. Strict infection control measures, including hand hygiene, proper use of personal protective equipment (PPE), and environmental disinfection, are crucial to mitigate the spread of Candida auris. Colonization with Candida auris can persist for months, or even indefinitely, even after an acute infection is treated and resolves. This means you could continue to harbor the fungus on your skin or other body sites, even without showing symptoms of infection.

Take care.

Regards.