Dec 14th, 2023

The Missouri Department of Health and Senior Services (DHSS) has issued a health alert regarding the emerging Candida auris infection cases in Missouri healthcare facilities.

C. auris is an emerging multi-drug resistant yeast that was discovered in 2009 in Asia, and has since spread worldwide. The earliest known case in the United States was in 2013. Due to resistance to many antifungal drugs, C. auris is considered an urgent antimicrobial resistance threat by the Centers for Disease Control and Prevention (CDC). C. auris spreads easily in health care settings and is difficult to treat due to drug resistance. Invasive infections with C. auris are particularly concerning and have caused death in about one in three persons who developed severe disease due to this infection.

There were 2,377 clinical cases and 5,754 colonization/screening cases identified from January 2022 - December 2022 across 29 states (CDC C. auris tracking tool). It was first seen in Missouri in late 2020. Until this most recent increase in cases, there were only two cases reported in Missouri and both had acquired infection in other states with known high incidence of C. auris.

Since October 2023, Missouri DHSS has detected eight additional cases of C. auris with the majority in the St. Louis Metro area.

From the 10 cases reported in Missouri:

  • Patient age ranges from 36 to 83 with a median age of 67.
  • Three patients reported receiving health care in geographic areas with a high C. auris incidence.
  • All patients reported to have history of complex medical care (including invasive medical devices, wounds, and underlying conditions).
  • All patients currently infected or colonized with C. auris resided in a skilled nursing facility or have had hospitalizations within the last 12 months.

C. auris mostly affects individuals with severe underlying conditions, those requiring complex medical care, as well as those with indwelling devices. Patients with invasive medical devices like breathing tubes or catheters tend to be at increased risk for infection. Healthy people without these risk factors, including health care workers and family members, have a low risk for becoming infected with C. auris.

Please read Missouri DHSS's full Health Alert, which includes details about transmission, symptoms, diagnosis, treatment, and recommendations (prevention/precautions) for healthcare facilities. It provides important information to medical and public health professionals, and to other interested people in our community.