Deadly, drug-resistant fungus poses healthcare concern in the US

March 13, 2017

A drug-resistant and fatal fungal infection is causing concern among healthcare authorities in the US as it has already infected more than 30 people in the country after warnings were issued in June 2016.

The fungus, a strain of a yeast called Candida auris, has been spreading worldwide, infecting people in dozens of country since its 2009 discovery in a patient with ear infection in Japan. The fungus has since been reported in the United Kingdom, Venezuela, South Korea, Pakistan, Kuwait, Kenya, Colombia, and Israel.

Unlike other forms of yeast infection, this fungal infection poses more serious threats such that it infects the bloodstream and spreads from person to person in healthcare settings.

Other candida infections affect the throat, vagina, and the mouth, but invasive yeast infections are known to affect the heart, brain, bones, eyes, and other parts of the body, which makes them more dangerous.

The fungus is also able to survive on the skin for months and on hospital equipment such as chairs and bed rails for weeks. Some strains were likewise found to be resistant to all of three major classes of antifungal drugs.

In the US, 71% of the C. auris strains showed some resistance to drugs, which makes treatment more difficult.

Health officials said that the pathogen is among a group of newly emerging drug-resistant threats. Thirty-five infected patients were identified so far, and another 18 were found carrying the organism albeit they were not sickened by it.

“Based on laboratory testing, the U.S. strains were found to be related to strains from South Asia and South America. However, none of the patients travelled to or had any direct links to those regions. Most patients likely acquired the infections locally,” CDC said in a statement after it released its first report to describe cases of the infection in the United States.

Sixty percent of identified cases were fatal. Many of those who died had other serious illnesses. Individuals with increased risk for infections are those who recently had surgery. Those with broad-spectrum antibiotic and antifungal use, patients with diabetes, and those with central line catheters inserted in a large vein are also vulnerable to infection.

With at least 28 infected individuals, New York has the most number of infections in the US albeit there are also reported cases of infection in Maryland, Illinois, Massachusetts, and New Jersey.

The US Centers for Disease Control and Prevention (CDC) sent an urgent alert to clinicians last June 2016 to be on the lookout for infections.

“Experience outside the United States suggests that C. auris has high potential to cause outbreaks in healthcare facilities. Given the occurrence of C. auris in nine countries on four continents since 2009, CDC is alerting US healthcare facilities to be on the lookout for C. auris in patients,” the CDC warned.

Infection requires specialized laboratory methods to be accurately detected. Conventional laboratory techniques may lead to misidentification and even inappropriate treatment that can pose challenge to controlling the spread of infection in healthcare settings.

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Category: Features, Health alert

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