Candida Auris: Everything You Need To Know
Candida auris is a fungus in the candida family. It has become infamous in the scientific community for being resistant to common antifungals.
Outbreaks of this fungus almost always occur in hospitals or homes for older adults. In addition, they can be very serious and even lead to sepsis. The spread of the infection is through the patient’s blood.
Researchers first identified this organism in 2009. It was then named auris, because it was in a sample of the ear canal of a patient, a native of South Korea. Subsequently, outbreaks in hospitals in 2016 and 2017 set alarm bells ringing.
The most serious outbreaks occurred in the intensive care unit. This led to extreme measures to control the contamination. However, it was realized that this fungus is very resistant.
Researchers assumed that living in a hospital environment made the fungus resistant to medication. Samples from hospital floors, operating room furniture and even computers have tested positive for Candida auris.
Cases of Candida auris
After confirming the first case of Candida auris in 2009, the researchers figured that previous unidentified infections probably also came from the fungus. One case in particular from 2008, also in South Korea, could have been caused by it.
From there, scientists investigated cases in
- India
- South Africa
- Venezuela
- The United Kingdom
- Israel
- The United States
These last two countries registered it in 2016 along with Spain and Colombia. There were even several outbreaks that year.
There are two major hospital admissions. The first took place at the Royal Brompton Hospital in London in 2015. The other was at La Fe Hospital in Valencia, Spain in 2016. Each outbreak affected a significant number of hospital admissions.
The risks of Candida auris
Not everyone who comes into contact with Candida auris will get the infection. Also, not everyone will have severe symptoms. In addition, there are people who carry the fungus in their bodies and never develop symptoms. This is called colonization. Although it is not serious for the carriers, they can pass it on to other people.
The main risk factor for infections is hospitalization. You may also need a catheter.
Other risk factors include:
- being quarantined in a nursing home
- many anti-fungal drugs
- many hospital visits
drug resistance
A surprising feature of Candida auris is its resistance to antifungals. This is a major concern for infectious disease specialists. Hospital outbreaks are a cause for alarm, as we don’t know how difficult it will be to get rid of the fungus.
Almost all Candida varieties are sensitive to fluconazole. For example, it is common to treat Candida albicans with this drug. Candida auris, however, is resistant to it.
It is resistant to other antifungal agents, such as amphotericin B and voriconazole. According to scientific studies, about 90% of registered Candida auris strains are resistant to one class of antifungal agents. In addition, a third of them are resistant to more than two different drugs.
Therapy
Until now, there is a special group of drugs that can help kill Candida auris. These drugs are called echinocandins. However, these are not always available. Certain strains of the fungus are even resistant to this. When this happens, doctors use a mixture of antifungals in higher than usual doses.
Also, these patients had a previous illness that required hospitalization. Therefore, their immune system was weak. Some patients even had several diseases at the same time. The doctors have to figure out how to treat each problem.
This critical situation around Candida auris reminds us to be careful when taking medications. Both patients and doctors must follow the prescriptions to avoid developing drug resistance.
