Health authorities in the United States and the United Kingdom are alerting hospitals (and Nigerians can take cue too) and testing labs to be on the lookout for an emerging multidrug-resistant yeast in patients that is causing invasive infections that can kill, in healthcare settings.
The yeast, Candida Auris, was first brought to the attention of medical authorities in 2009 in Japan, outbreaks of the yeast infections have now occurred in nine countries across four continents; some of the countries include South Korea, South Africa, India, and Kuwait.
Infections have also been identified in Colombia, Pakistan, the U.K., and Venezuela, although these are not detailed in any published reports, note the CDC.
Patients who have been in intensive care for a long time appear to be particularly susceptible to invasive infection by C. Auris.
There are three main reasons to be concerned about C. Auris infections, say the CDC. First, it is often multidrug-resistant; second, it is difficult to identify; third, it has caused outbreaks in hospital settings.
C. Auris can enter the bloodstream and spread through the body, causing severe invasive infection. It often does not respond to commonly used antifungal drugs, making infections difficult to treat. The yeast can also cause wound infections and ear infections.
Why C. auris has recently emerged in so many different places is somewhat of a mystery. Molecular analysis of strains suggests while they are related within a country or region, they are highly distinct between continents.
Looking back at testing of samples have revealed that the earliest known infection with C. auris was in South Korea in 1996.
C. auris can only be identified reliably with molecular analysis; conventional lab techniques can mistakenly confuse it with another related fungus. Misidentification leads to the wrong treatment and raises the chance of the infection spreading to other patients.
C. Auris is in the same family as C. albicans – the yeast that causes thrush infections in the genitals and mouth – C. auris has also been found in urine and respiratory samples. However, it is not clear whether it causes infections in the lung or bladder.
There is not much data on risk factors for C. auris infections, but the CDC say evidence suggests these are much the same as for other types of Candida infections, including recent surgery, diabetes, use of broad-spectrum antibiotics and antifungals, and use of central venous catheter (catheter in a large vein).
Patients who have been in intensive care for a long time appear to be particularly susceptible.
More work needed to understand C. auris
The CDC note it is unlikely that travel to the countries with known outbreaks of C. auris will increase a person’s chance of becoming infected with the yeast, as infections have primarily affected patients who were already in the hospital for other reasons.
However, certain infection control measures – such as strict hand hygiene and wearing gowns and gloves – are likely to prevent spread. Thorough environmental cleaning of hospital rooms could also help. Other measures include screening of patients, isolation of those infected, and temporary closure of affected wards to enable thorough deep cleaning with an approved, fungus-targeting product.
The CDC say:
“C. auris may not represent a new organism so much as one that is newly emerging in various clinical settings. Although the causes for such emergence are unknown, they may include new or increasing antifungal selection pressures in humans, animals, or the environment.”