Medical illustration of Candida. (CDC) 
 
 U.S. health officials are warning hundreds of thousands of clinicians in hospitals around the country to be on the lookout for an emerging and highly drug-resistant type of yeast that is causing potentially fatal infections in hospitalized patients around the world. 
 
 Most people are familiar with the garden variety kind of yeast infections that people get on the skin or in their genitals. But invasive yeast infections can be fatal, especially for patients in intensive care or having surgery. Others at risk include people with diabetes, patients taking powerful antibiotics and antifungal medications, and those with catheters. 
 
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 This emerging strain of yeast, known as Candida auris, has triggered outbreaks in health-care settings, causing bloodstream, wound and ear infections. Since 2009, the pathogen has been found in nine countries on four continents, including one possible infection in the United States in 2013. 
 
 The Centers for Disease Control and Prevention sent a clinical alert late last week to U.S. health-care facilities and dozens of medical societies to share with their members. 
 
 “CDC is concerned that C. auris will emerge in new locations, including the United States,” the alert said. The infections have most commonly been acquired in hospitals and occurred several weeks into a patient's hospital stay. 
 
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 Officials warn that the yeast doesn’t respond to common antifungal drugs and is difficult to identify with standard laboratory methods. 
 
 “What concerned us is that it is potentially resistant to one or two, if not all three” main classes of antifungal drugs used to treat these infections, said Tom Chiller, the CDC’s top fungus expert, in an interview Tuesday. 
 
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 Invasive infections with any type of Candida can be fatal. Based on information from a limited number of patients, 60 percent of people with this new type of Candida infection have died, but it’s not clear how many of them had other serious illnesses that also increased their risk of death. 
 
 Most hospital labs in the United States also don’t have the capacity to identify the new strain because it can be confused with other more common types of yeast. As a result, misidentification could lead to inappropriate treatment, he said. 
 
 That’s particularly important with this organism because the limited data so far suggests that the infections have occurred primarily in patients who were already in the hospital for other reasons. Unlike other types of yeast that typically spread from person to person, “this one seems to get into hospital settings and stay there,” Chiller said, and may spread from contact with the environment, such as contaminated surfaces or equipment. 
 
 The organism was first identified in 2009 in Japan from a patient’s external ear discharge. Infections have also occurred in South Korea, India, South Africa, Kuwait, Pakistan, Colombia, Venezuela and the United Kingdom. Because identification requires specialized laboratory methods, the CDC alert said infections likely occurred in other countries but have not been identified or reported. 
 
 Based on a review of specimens collected in the past, CDC officials said they are aware of one possible infection in the United States in 2013 that was collected by a private lab. The CDC has tested a small sample of Candida specimens over the last eight years, and so far the deadly new yeast has not turned up. But the testing is limited, he said — there’s surveillance at only four sites in the country, and only about 7,000 samples have been analyzed. 
 
 The CDC is recommending that hospitals and other health-care facilities that suspect they have a patient with such an infection contact local public health authorizes and the CDC. They also recommend that patients carrying or infected with this organism have their own rooms, and that their rooms are thoroughly cleaned and disinfected every day with an EPA-registered, hospital-grade disinfectant that targets fungus. 
 
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 Zika infections last longer in pregnancy, monkey study shows ||||| The U.S. Centers for Disease Control and Prevention is warning clinicians to be on the lookout for an emerging, infectious yeast called Candida auris. Healthcare facility-associated outbreaks around the world have revealed that the invasive yeast is resistant to typical concentrations of the three major classes of available antifungal drugs. Representative drugs include fluconazole, amphotericin B and caspofungin. 
 
 The C. auris yeast causes bloodstream infections, wound infections and otitis (ear infections). The most common risk factors are having an indwelling venous catheter, urinary catheter, recent surgery, previous courses of antibiotics or antifungals and prolonged hospitalization. Death can occur 30-50% of infected patients. 
 
 One concern is that C. auris infections can masquerade as other types of less-problematic yeast infections and require specialized detection methods that are not available at all hospitals. 
 
 Global emergence 
 
 Moreover, health officials are puzzled by how C. auris has emerged so quickly over a wide geographical area–nine countries on four continents–since first described in a Japanese patient in 2009. So far, only one case, in 2013, is known to have occurred in the U.S. 
 
 But why has it become so widespread? DNA analysis shows that the yeast isolates are related within a given geographical region but not across continents. Is there some sort of environmental pressure that's causing C. auris infections to become more prevalent or are global health officials simply paying more attention? 
 
 Two countries have had outbreaks of more than 30 patients each and molecular evidence suggests that the infection is passed around within a given hospital. Although the mode of transmission is unknown, extra care should be paid to infection control procedures and room disinfection. 
 
 What clinicians and patients should know 
 
 With all of these questions, it makes sense that the CDC should be making U.S. clinicians aware of Candida auris infections. CDC stresses that clinical, state and public health laboratories should be aware of this organism and the limitations in its precise identification, as not all labs identify Candida infections down to the species level. Moreover, C. auris can be misidentified as Candida haemulonii and even the brewer's yeast, Saccharomyces cerevisiae. 
 
 If you or a family member is hospitalized and is diagnosed with a new yeast infection during their stay, share this CDC alert with the healthcare team. Specifically ask the doctor or mid-level provider if they know about the new CDC warning on drug-resistant Candida auris (pronounced OR-iss). 
 
 If you are in healthcare, these are the specific interim recommendations from the CDC, including a request to submit diagnostic information and isolates: 
 
 Reporting—Healthcare facilities who suspect they have a patient with C. auris infection should contact state/local public health authorities and CDC (candidaauris@cdc.gov). 
 
 Laboratory Diagnosis—Diagnostic devices based on matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) can differentiate C. auris, but not all devices currently include C. auris in the reference database to allow for detection. Molecular methods based on sequencing the D1-D2 region of the 28s rDNA can also identify C. auris. CDC requests that laboratories identifying C. auris isolates in the United States notify their state or local health departments and CDC (candidaauris@cdc.gov). C. haemulonii isolates and other isolates from clinical specimens that cannot be identified beyond Candida spp. by conventional methods can be forwarded through state public health laboratories to CDC for further characterization. 
 
 Infection Control—Until further information is available, healthcare facilities should place patients with C. auris colonization or infection in single rooms and healthcare personnel should use Standard and Contact Precautions. In addition, state or local health authorities and CDC should be consulted about the need for additional interventions to prevent transmission. CDC is working with domestic and international partners to develop definitive infection control guidance. 
 
 Environmental Cleaning–Anecdotal reports have suggested that C. auris may persist in the environment. Healthcare facilities who have patients with C. auris infection or colonization should ensure thorough daily and terminal cleaning and disinfection of these patient’s rooms using an EPA-registered hospital grade disinfectant with a fungal claim. 
 
 David Kroll, PhD, is a former academic pharmacologist and educator. For more health and pharmaceutical news and commentary, follow him on Facebook, Twitter @DavidKroll or here at Forbes.
– The CDC warned American hospitals last year to keep an eye out for the emergence of a possibly fatal, drug-resistant yeast infection, and now the agency's fears may be realized. CDC officials tell the Washington Post that 35 patients in the US have been stricken with Candida auris, a fungus that can cause bloodstream, wound, and ear infections, with another 18 people harboring the microbe without becoming ill. Some strains of the pathogen don't respond to the three main classes of antifungal drugs, and based on the small number of cases health officials have had the chance to review, 60% of patients hit with C. auris have died (though the agency notes many of those patients had other serious medical issues they were contending with). The fungus is contagious and durable, especially in health care facilities, where it can stick around on furniture and other equipment for months. The first C. auris strain was reported in 2009 in a Japanese man, and it has since spread around the globe, including to Colombia, India, Israel, Kenya, Kuwait, Pakistan, South Korea, Venezuela, and the UK. The first US case was reported in 2013, and the CDC's latest report places 28 of the incidents in New York state, with other affected states including New Jersey, Maryland, Massachusetts, and Illinois. CDC Acting Director Anne Schuchat said at a recent briefing that "scary," "difficult to combat" drug-resistant microorganisms are on the rise, per the Post. Some good news is that C. auris hasn't morphed yet into new strains, and most people's chances of contracting it are very low, with it only affecting "the sickest of the sick," says CDC infectious disease specialist Tom Chiller. Also encouraging: a recent study IDing an antifungal that may prove useful. (No drug could save this Nevada woman.)