At the end of March 2023, the US Centers for Disease Control and Prevention highlighted the threat from a rapidly spreading fungus called Candida auris that causes infections and deaths among hospital patients across the country. The unexpected emergence of this recently discovered pathogen is part of a larger trend of increasing fungal infections in the US
Arif R. Sarwari is a physician and professor of infectious diseases at West Virginia University. Amid rising concerns among doctors and public health officials, Sarwari helped explain what Candida auris is, how it spreads and how concerned people in the US should be.
1. What is Candida auris?
Candida auris is a recently identified, single-celled fungus that can infect humans and is moderate resistant to existing antifungal drugs. You may be familiar with superficial yeast infections, such as athlete’s foot or vaginal yeast infections, which are quite common and pose no significant risk to most people. Unlike, Candida auris and other related fungi can cause infections in a person’s body And his much more dangerous.
Candida auris is a type of yeast first identified in 2009 and is one of the species in the candida family that can infect humans. In the past, most were invasive candida infections caused by Candida albicans. However, recently there have been infections with species of candida that are much more resistant to drugs than Candida albicans – like it Candida auris – shot up, with a near quintupled since 2019.
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2. How Dangerous Are Candida Infections?
In general, healthy people do not need to worry about invasive candida infections. There are two groups of people who are most at risk for dangerous candida infections: First, there are patients in intensive care units who also have central intravenous catheters and receive broad-spectrum antibiotics. Patients with weak immune systems, such as cancer patients undergoing chemotherapy or those with human immunodeficiency virus, are also at high risk for candida infection.
Candida fungi grow in almost all humans in their guts and on their skin as part of their microbiome. When a person is healthy, candida numbers are low, but the fungi can multiply quickly and overcome a person’s immune system when a patient is sick. sick and on antibiotics.
If candida cells on a person’s skin contaminate an intravenous line, the fungus can enter a patient’s bloodstream and often cause fatal bloodstream infections. Candida species are the fourth most common cause of candida hospital-associated bloodstream infections.
There are three classes of antifungal drugs that can be used fight invasive candida infections. Candida albicans is susceptible to all three and easier to treat than Candida auristhat’s mediocre resistant to all three classes of antifungal agents.
3. How common are invasive fungal infections?
The CDC estimates that in the US around 25,000 patients get candida bloodstream infections every year.
Candida bloodstream infections are best understood as a tale of two eras. In the past, they were almost always caused by a drug Candida albicans that originated endogenously from a patient’s own microbiome. There was no concern about spreading infections to other patients.
The recent emergence of drug resistant and more transmissible Candida auris is to alarm among health workers. Because this species can contaminate surfaces and spread easily from patient to patient, the fungus causes both outbreaks within and between hospitals.
4. Why Are Yeast Infections Increasing?
Fungal infections have been on the rise in the US in recent years, especially infections caused by Candida auris. The pathogen caused only a few infections per year between 2013 and 2016, but from 2017, infections started to increase rapidly with 2,377 confirmed cases registered in 2022 According to the CDC. The number of deaths from all candida infections is also rising, from 1,010 in 2018 to nearly 1,800 in 2021.
The reasons for this increase are complicated, but I think there are two main causes: more, sicker patients in hospitals and a stressed health system, both of which got worse during the COVID-19 pandemic.
Hospitals are seeing more seriously ill patients with weak immune systems, especially as the population ages. This means there are more sensitive patients in hospitals to begin with.
Moreover, whenever the health system is under stress – such as during a pandemic – it is impervious to drugs bacterial and fungal infections increase. This is because very sick patients are usually in overcrowded wards and exposed to many antibiotics. In addition, the loss of hospital staff and increased workload results in lower quality sanitation facilities, causing a greater spread of drug-resistant pathogens.
I like to see the emergence of drug-resistant fungi Candida auris through the same lens as worsening antibiotic resistance. The more antibiotics people use, the more likely a resistant strain will become dominant.
5. What can the medical community do about it?
There are a few options to counter the emergence of drug resistant drugs Candida auris.
are the most effective measures good practice for infection control. These behaviors and protocols include practicing good hand hygiene before and after each patient contact, wearing isolation gowns and gloves that are carefully disposed of in a patient’s room, and taking steps to Candida auris infections early and isolate patients to prevent spread. While relatively simple, these actions are essential to prevent the spread of all antibiotic-resistant pathogens, not just fungi.
The second option is to develop better drugs to treat new, antifungal-resistant strains of Candida. Many new antifungal drugs are already under development. However, prevention through proper infection control will always remain fundamental, as further drug development is akin to an arms race.
