Emerging Pathogens of Concern

Clinical Practice

In recent weeks, reports about monkeypox and Candida auris cases in the US have been released. It is important to have a basic understanding of early identification and continued infection prevention and control to help protect residents, staff, and facilities.  
Candida auris is an emerging fungus with resistance to most antifungal medications that presents a global health threat. It was initially found in the New York, Chicago, and Los Angeles regions, but has spread to 27 states. In some patients, this fungal yeast can enter the bloodstream and spread throughout the body, causing invasive infections. Patients who have been hospitalized in a health care facility long term, have central venous catheters or other lines or tubes entering their body, or have previously received antibiotics or antifungal medications, appear to be at highest risk of infection with this yeast. The CDC is concerned about Candida auris for three main reasons: 

  1. It is often multidrug-resistant, meaning that it is resistant to multiple antifungal drugs commonly used to treat Candida infections. Some strains are resistant to all three available classes of antifungals. 

  2. It is difficult to identify with standard laboratory methods, and it can be misidentified in labs without specific technology. Misidentification may lead to inappropriate management. You should talk to your local or state public health department about testing for this strain.  

  3. It has caused outbreaks in health care settings. For this reason, it is important to quickly identify Candida auris in a patient so that healthcare facilities can take special precautions to stop its spread. You should ask your hospital infection prevention team if they have any cases of Candida auris. 

The CDC has created a dedicated Candida auris webpage and a fact sheet that can be downloaded.  

Monkeypox is a zoonotic viral infection endemic to several Central and West African countries. Since May 2022, monkeypox cases have been identified in at least 18 US states and territories among persons returning from international travel and their close contacts domestically. Monkeypox is rare and does not spread easily between people without close contact and the threat to the general US population is currently considered low. The CDC is urging health care providers to be alert for patients who have rash illnesses consistent with monkeypox and notify their local public health agency.  
People who may be at higher risk for contracting monkeypox may include, but are not limited to, those who: 

  • Had contact with someone who had a rash that looks like monkeypox or someone who was diagnosed with confirmed or probable monkeypox. 
  • Had skin-to-skin contact with someone in a social network experiencing monkeypox activity. 
  • ​Traveled outside the US to a country with confirmed cases of monkeypox or where monkeypox activity has been ongoing. 
  • Had contact with a dead or live wild animal or exotic pet that exists only in Africa or used a product derived from such animals (e.g., game meat, creams, lotions, powders, etc.). ​

The CDC has created a Frequently Asked Questions page and a dedicated monkeypox webpage