Antimicrobial Resistance

Antimicrobial Resistance (AR) occurs when bacteria, viruses, fungi, and parasites change over time and no longer respond to medications used to cure them. This makes infections harder to treat and increases the risk of disease spread, severe illness, and death. It does not necessarily mean that a germ is resistant to all antimicrobial treatments, but over time, this can become a concern. AR pathogens can cause healthcare-associated infections (HAIs), which are infections that patients can get while receiving healthcare. HAIs can occur in many different kinds of healthcare facilities. HAIs can be caused by a wide variety of common and unusual organisms. 

The County of San Diego HAI program is dedicated to reducing the burden of HAIs and AR pathogens in healthcare systems. On this page, healthcare workers can learn more about AR Pathogens that threaten our healthcare systems and how to prevent the spread.

On this page

• Candida auris (C. auris)
  • C. auris resources
• Carbapenem-resistant Acinetobacter baumanni (CRAB)
  • CRAB resources
    
• Carbapenem-Resistant Enterobacterales (CRE)
• Carbapenem-Resistant Pseudomonas Aeruginosa (CRPA)

Candida auris (C. auris)

What is C. auris?

• C. auris was first identified in San Diego County in 2021.
• C. auris is a fungal pathogen that can cause serious infections. It can spread in healthcare facilities. 
• Patients can carry C. auris on their bodies, even if it is not making them sick. This is called colonization. 
• When people in hospitals and nursing homes are colonized with C. auris, it can spread to other people or contaminate the patient care environment and equipment. 

Why is C. auris a concern?

• C. auris is often multidrug-resistant, meaning that Candida infections may no longer respond to the medicines used to treat them. 
• It has caused outbreaks in healthcare settings. Therefore, it is important to identify C. auris so that healthcare facilities can take special precautions to stop its spread. 

How can the spread of C. auris be prevented?

• Carefully follow infection control measures as outlined by the Centers for Disease Control and Prevention for C. auris
  • Good hand hygiene
  • Contact precautions 
  • Thoroughly clean and disinfect the patient care environment and equipment with an effective disinfectant
  • Inter-facility communication of people's status of C. aruis
  • Screening high-risk patients
  • Lab surveillance

• County of San Diego
  • Materials

• California Department of Public Health (CDPH) HAI Program — C. auris
  • YouTube — Prevention of Candida auris and other novel MDROs in healthcare facilities webinar 12/10/2020 FINAL

• Centers for Disease Control and Prevention (CDC) —  C. auris
  • General Information
    • C. auris: A drug-resistant germ that spreads in healthcare facilities | Haitian Creole | Korean | Spanish | Vietnamese
    • General Fact Sheets
    • Drug-Resistant C. Auris
    • Drug-Resistant Candida Species
  • Information for Patients 
    • C. auris Colonization Information for Patients  | Haitian Creole | Korean | Spanish | Vietnamese
    • C. auris Testing | Spanish
  • Information for Infection Preventionists
    • Candida auris: A drug-resistant fungus that spreads in healthcare facilities | Spanish
  • Information for Laboratory Staff
    • Candida auris: A drug-resistant fungus that spreads in healthcare facilities | Spanish
    • Screening Script auris Testing | Spanish

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Carbapenem-resistant Acinetobacter baumannii (CRAB)

• Acinetobacter is a group of bacteria (germs) commonly found in the environment, (e.g., soil and water). While there are many types, the most common cause of infections is Acinetobacter baumannii, which accounts for most Acinetobacter infections in humans. Acinetobacter baumannii can cause infections in the blood, urinary tract, lungs, wounds, or other parts of the body. It can also colonize, or live on a person, especially in their respiratory secretions (sputum) or open wounds without causing infections or symptoms.

Why is CRAB a concern?

• Carbapenems are a class of very powerful antibiotics, often only used to treat severe infections. 
• Acinetobacter, and many other bacteria, are able to adapt quickly so antibiotics are not effective in treating infections, including carbapenem antibiotics. This results in the inability to effectively treat infections caused by CRAB, and other similar pathogens.

How can the spread of CRAB be prevented?

• Carefully follow infection control measures as outlined by the Centers for Disease Control and Prevention for CRAB.
  • Good hand hygiene
  • Contact precautions 
  • Thoroughly clean and disinfect the patient care environment and equipment with an effective disinfectant
  • Inter-facility communication of people's status of CRAB
  • Screening high-risk patients
  • Lab surveillance

• County of San Diego
  • Materials

• CDPH HAI Program
  • General Information 
    • CRAB
• CDC
  • General Information
    • About Antibiotic Resistance
    • Acinetobacter in Healthcare Settings

 Carbapenem-Resistant Enterobacterales (CRE)

Carbapenem-Resistant Pseudomonas Aeruginosa (CRPA)

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For more information, contact the San Diego HAI program through our contact form, via e-mail at phs.hai.hhsa@sdcounty.ca.gov, or call the Epidemiology Unit at (619) 692-8499.