The microscopic yeast strain Candida auris, also known as C auris, has been detected in more than half of the US states since it first appeared in the US in 2016.
Health officials issued a warning about the fungus on Monday, noting that the hospital infection had tripled in recent years and had become resistant to multiple drugs.
The Centers for Disease Control and Prevention (CDC) already described the infection, which kills up to 60 percent of the people it infects, as an “urgent threat” in 2019.
The symptoms of the fungus may not be noticed because C auris patients are usually already ill with another serious condition and are often in hospital.
Most transmission occurs in health care settings, especially among residents of long-term care facilities or among people with indwelling devices, such as catheters, tracheostomy or wound drains, or on mechanical ventilators.
Fever and chills
Symptoms depend on the part of the body that is infected, but the most common sign seen in patients with Candida auris is fever and persistent chills.
Fever is defined as a temporary increase in average body temperature above 99°F to 99.5°F. But with a C. auris infection, the higher temperature will not go away.
The most common sign in patients with Candida auris is persistent fever and chills.
Chills are the body’s way of raising your core temperature through shivering.
Fever and chills are the most common symptoms of C. auris bloodstream infections. Bloodstream infections can also cause confusion and disorientation.
Cowries can also live on the skin or other parts of the body, such as the ear or wounds, without causing an active infection and making you sick.
But in some patients, the fungus can enter the bloodstream and spread throughout the body, resulting in life-threatening invasive C. auris infections, such as in the blood or internal organs.
This usually occurs when a medical device is inserted into the skin or gastrointestinal tract, such as a catheter or IV line.
Antibiotics don’t work
Another telltale sign of C. auris is that the fever and chills cannot be treated with antibiotics because of a suspected bacterial infection.
Antifungal medications may also be ineffective. Some C. auris infections have been resistant to all three types of antifungal drugs: azoles, echinocandins, and amphotericin B. Echinocandins are the first line of therapy given to treat C. auris.
Both antibiotics and antifungal medications can be ineffective against C. auris infections.
Multidrug-resistant strains of C. auris have become more common in recent years.
Research by the CDC found that cases of the echinocandin-resistant fungus had also increased: in 2021 there were about three times as many cases as in each of the previous two years.
If the C auris fungus has reached the ear, patients may have a sharp or dull pain in the ear canal.
There may be a “full” feeling in the ears and hearing problems due to the damping. Drainage and nausea may also occur.
Patients can lose partial function of their ears if a C. auris infection takes root in the ear canal.
The first case of C auris was found in the ear discharge of a 70-year-old female patient at the Tokyo Metropolitan Geriatric Hospital in Japan in 2009.
The fungus kills more than one in three people with invasive C auris, where it has spread to cause an infection, such as in the ear.
Cowries can infect an existing open wound that is healing.
The skin around the wound may become inflamed and red. This is due to the irritation caused by the dilation of the blood capillaries.
The skin around an existing wound can become inflamed and red if the patient contracts cowries.
Yellowish or orange pus may also be discharged from the wound.
The wound will be more painful and tender to the touch and will take longer to heal.
There may also be an accompanying fever.
Tiredness and general malaise
General tiredness and malaise is another sign of a bloodstream infection caused by C. auris.
It is believed that the feeling of fatigue is a signal for the body to stop physical activity to recover.
General tiredness and discomfort during a C. auris infection can be a signal for the body to stop being physically active.
Bloodstream infection can also cause sepsis, which can be life-threatening. It occurs when chemicals in the bloodstream to fight an infection trigger inflammation throughout the body.
This can cause multiple organ systems to become damaged and shut down.
Symptoms of sepsis include shortness of breath, low blood pressure, increased heart rate, and mental confusion.
C auris infections have been growing rapidly recently, with cases in the US increasing from 1,310 in 2020 to 4,041 in 2021. Last year there were 5,754 cases.
The CDC does not keep track of how many people have died from cowries, and it can be difficult to know if patients died from the fungus, since it usually infects people who are already very sick.
CDC data shows that fungal infections caused 7,000 deaths in 2021 in the US and 1.5 million worldwide.
The states most affected are those with the largest number of hospitals, the breeding ground for C. auris.
The fungus does not form germ tubes and is rarely detected in the natural environment.
Healthy people rarely get sick, but among the frail and vulnerable, it kills up to 60 percent.
People contract C. auris by touching an infected person. It can also be transmitted by touching contaminated surfaces or equipment, where it can survive for weeks.
C auris emerged over a decade ago in hospitals in India, South Africa and South America simultaneously. The researchers don’t know why, but they speculate that climate change might have played a role.
Fungi generally cannot tolerate the warmer temperature of the human body, but scientists believe that C auris may have adapted to survive in a warm environment.
Another theory suggested in 2019 was that C. auris could have existed as a plant fungus that adapted due to global warming to exist in salt water, as well as higher temperatures.
The type of plant would have been a saprophyte, which has no chlorophyll but instead gets its food from dead organic matter.
Researchers at the University of Texas speculated that it could have been transmitted by birds from marshes around the world to rural areas where birds and humans are often in contact.
Researchers theorized about the appearance of Cowries
C. auris could have jumped to humans during activities like agriculture, and eventually into hospitals and health care systems when humans migrated to cities.
A research team in India noted that C auris originated in a tropical wetland and gained antifungal resistance after coming into contact with humans.
There are approximately 1,500 types of yeast, which are single-celled fungi. They are found globally in soil and in plants. Hundreds of varieties are used to make things like bread, beer, and wine.
Some yeasts are dangerous pathogens for humans and other animals, notably Candida albicans, of which C auris is a type.