The US Centres for Disease Control has released a report in which it identifies over a dozen cases of a deadly, antibiotic-resistant fungus called Candida auris. It’s the first time this super-strain has been found in the US, and disturbingly, four of the first seven patients infected with it have died.
Candida auris. (Image: CDC)
Scientists have known about the fungus since 2009 when it was first identified from the ear canal discharge of a patient in Japan. Since then, infections have been reported in several other countries, including South Africa, the United Kingdom, India and others. And now, as the CDC reports, the fungus has finally made its way to the United States – and it’s likely been lurking in the country since 2013. This serves as another potent reminder that the antibiotic era is quickly coming to an end.
Candida auris causes a nasty and often fatal infection that’s typically treated with a class of antifungal drugs called echinocandins. But some isolates of this globally emerging health threat were found to be resistant to all three major classes of antifungal medications. The fungus can trigger infections in the bloodstream, wounds and inside the ear. Complicating matters, the organism is difficult to identify using standard biochemical methods, and it’s often misidentified as other yeasts (typically Candida haemulonii, Candida famata, Saccharomyces cerevisiae and Rhodotorula glutinis).
“It appears that C. auris arrived in the United States only in the past few years,” noted Tom Chiller of the CDC’s Mycotic Diseases Branch, in an agency release. “We’re working hard with partners to better understand this fungus and how it spreads so we can improve infection control recommendations and help protect people.”
Seven of the cases described in the new report occurred between May 2013 and August 2016. They were discovered in four states: New York, Illinois, Maryland and New Jersey. All cases were found in patients, prompting the CDC to say these findings “suggest that C. auris could be spread in healthcare settings”. All of the seven patients had underlying medical conditions, so it’s not clear if the four who died were actually killed by the fungus. Sixty per cent of patients who acquired the infection died, but given the small sample size, it’s not clear just how deadly this fungus actually is. The other six cases were discovered after the period covered in the report and are still being investigated.
Lab tests show that the US strains were related to strains from South Asia and South America, but none of the patients travelled or had direct links to those locations. This strongly suggests that the patients acquired their infections locally. Disturbingly, this organism can spread quite easily; a sweep of the Illinois patient’s hospital room revealed traces of C. auris in his mattress, bedside table, bed rail, chair and windowsill.
The CDC has been warning about C. auris since 2013 when it issued a report describing antibiotic resistant threats that required prompt attention. In light of this finding, the CDC is recommending that healthcare professionals implement strict Standard and Contact Precautions to control and prevent the spread of this vile fungus.