A new report from the Centers for Disease Control and Prevention (CDC) details outbreaks of a drug-resistant superbug in hospitals and long-term care facilities in Washington, DC and Texas. While the fungus—Candida auris—isn't new, the report cites evidence that it is jumping from person to person, which hasn't been documented in the US before.
Between January and April 2021, 123 people were infected with the fungus in DC and Texas, which had a 30-day mortality rate of 30%, according to the report. Several of the infections were resistant to at least one drug and five were resistant to all three types of major antifungal medications that are usually used to treat these infections.
The director of the National Reference Centre for Invasive Fungus Infections, Oliver Kurzai, holding in his hands a petri dish holding the yeast candida auris in a laboratory of Wuerzburg University in Wuerzburg, Germany, 23 January 2018. There has been a recent rise of cases in Germany of seriously ill patients becoming infected with the dangerous yeast candida auris. Photo: Nicolas Armer/dpa (Photo by Nicolas Armer/picture alliance via Getty Images) doctors break it down.
First, what is Candida auris?
Candida auris—or C. auris—is a type of yeast or fungus that the CDC has dubbed a "serious global health threat." It can cause severe illness in people who are hospitalized and can even enter the bloodstream, leading to invasive infections.
The fungus is usually resistant to several antifungal drugs that are used to treat Candida infections. It's also hard to identify these infections using standard lab methods, which can leave people misdiagnosed and without proper treatment for too long.
Candida auris is known for causing outbreaks in healthcare settings, William Schaffner, MD, an infectious disease specialist and professor at the Vanderbilt University School of Medicine, tells Health. "This is a real problem among seriously ill patients," he says.
What causes a Candida auris infection?
Candida auris infections can spread in healthcare settings through contact with a contaminated surface or equipment, the CDC says. It can also spread from person to person.
The CDC also says that more information is needed to understand more about how the infection spreads.
What are the symptoms of a Candida auris infection?
This is where things get a little tricky. People who get Candida auris infections are usually already sick from another medical condition, the CDC says, so it can be hard to parse out the exact symptoms.
Still, the most common symptoms are fever and chills that don't get better after treatment with antibiotics.
Because Candida auris infections can be hard to diagnose through symptoms alone, the CDC says infections are usually found through cultures of blood or other bodily fluids—and special laboratory tests are needed to identify Candida auris infections specifically, weeding them out from other more common types of Candida.
How is a Candida auris infection treated?
If a Candida auris infection isn't drug-resistant, it will usually be treated with one of three major classes of medication: azoles, polyenes, and echinocandins.
But things get a little trickier if the Candida auris is resistant to those medications. "That complicates already complicated medical care," Dr. Schaffner says. "It puts us in a very difficult situation."
In these cases, doctors will do all they can to provide supportive treatment for the patient and hope their immune system can fend off the infection, he says. "Often, doctors have to scrape together some type of treatment regimen that is suboptimal in these situations," Amesh A. Adalja, M.D., senior scholar at the Johns Hopkins Center for Health Security, tells Health.
In some cases, Candida auris infections can be fatal, though the CDC says it's not yet known if Candida auris patients are more or less likely to die as compared to other Candida infections. When someone dies from Candida auris infection—or any Candida infection—it's usually because the person had other serious illnesses that also increased their risk of death.
So how worried should you be about drug-resistant Candida auris?
If you're a healthy person and not currently in a hospital or long-term care facility, you really shouldn't stress about this, Dr. Adalja says. "Candida auris is really unable to cause severe disease in healthy individuals," he says. "That is why cases are concentrated in healthcare facilities in nursing homes where frail individuals who are susceptible to it are."
Still, Dr. Adalja says, this "underscores the need to be very proactive when it comes to emerging infectious disease threats and to have a robust pipeline for new anti-microbial agents."
Overall, though, "the healthy general public doesn't have to fear this," Dr. Adalja says.
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