The Centers for Disease Control and Prevention (C.D.C.) discovered multiple instances of Candida Auris that were resistant to all medicines in two health institutions in Texas and a long-term care facility in Washington, D.C. for the first time.

According to researchers, a deadly, difficult-to-treat fungal infection spreading through nursing homes and hospitals across the United States is becoming even more dangerous. For the first time, the fungus, Candida Auris, was utterly impervious to all existing medication in several cases.

C. Auris
(Photo : Wikimedia Commons)

A Potent Yeast Infection

The discovery, announced by the Centers for Disease Control and Prevention on Thursday, is a concerning step in the evolution of C. Auris, a hardy yeast infection first found in Japan in 2009 and spreading rapidly throughout the globe.

During the coronavirus pandemic, federal health officials believe the disease has expanded even farther, with overburdened hospitals and nursing homes unable to keep up with the surveillance and control procedures needed to manage local outbreaks.

According to the C.D.C.'s recent study, five out of over 120 cases of C. Auris were resistant to therapy.

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Unreleased Information

The Centers for Disease Control and Prevention did not name the facilities where the novel infections occurred. Still, health officials said there was no apparent link between the outbreaks in Texas at a hospital and a long-term care facility that shared patients and in Washington, D.C. at a single long-term care center. Between January and April, epidemics occurred.

According to the C.D.C., about a third of infected patients died within 30 days, although officials said it was unclear if their deaths were caused by the fungus because they were already critically ill.

The Centers for Disease Control and Prevention has discovered more than 2,000 Americans colonized with C. Auris - meaning the fungus was found on their skin - during the last eight years, with most cases centered in New York, New Jersey, Illinois, and California. Approximately 5% to 10% of individuals infected with the virus develop more severe bloodstream infections.

Particularly Hard to Combat

The fungus is difficult to eradicate from healthcare institutions once it has established itself, sticking to cleaning carts, IV poles, and other medical equipment. While the yeast infection is usually innocuous to individuals in good health, it can be fatal to critically ill hospital patients, long-term care facility residents, and others with weaker immune systems.

Dr. Cornelius J. Clancy, an infectious diseases specialist at the V.A. Pittsburgh Health Care System, said, "If you wanted to conjure up a nightmare scenario for a drug-resistant virus, this would be it." "Immunocompromised patients, transplant recipients, and critically sick patients in the I.C.U. would all be at risk from an untreatable fungal infection."

While C. Auris has a reputation for being difficult to treat, researchers discovered five individuals in Texas and Washington, D.C. They had infections that did not respond to any of the three primary antifungal classes. In addition, Panresistance had previously been reported in three C. Auris patients in New York.

Still, health officials said the newly registered panresistant infections occurred in patients who had never received antifungal drugs, according to Dr. Meghan Lyman, a medical officer at the Centers for Disease Control and Prevention specializing in fungal diseases.

"What's alarming is that the individuals at risk aren't just a tiny group of folks who have infections and are already taking these medications," she added.

Hastened Spread

C. Auris
(Photo : Wikimedia Commons)

The coronavirus pandemic, according to infectious disease experts, has likely hastened the spread of the fungus. In addition, they claim that shortages of personal protective equipment, which hampered healthcare personnel in the early months of the epidemic, enhanced possibilities for the fungus to spread, particularly among the thousands of Covid-19 patients who were forced to use invasive mechanical ventilation.

The turmoil of recent months didn't help matters. "At the best of times, infection control efforts at most health care institutions are stretched tight, but with so many Covid patients, resources that could have gone to infection control were redirected elsewhere," Dr. Clancy said.

According to numerous health experts, the discovery of a panresistant C. Auris is a sobering reminder of the risks presented by antimicrobial resistance, from superbugs like MRSA to antibiotic-resistant salmonella. According to the Centers for Disease Control and Prevention, such diseases sicken 2.8 million Americans each year and kill 35,000.

Limiting the Spread of Infections

Health systems throughout the country are trying to limit the spread of such infections, according to Dr. Michael S. Phillips, a head epidemiologist at N.Y.U./Langone Health. He said the situation was particularly acute in major cities like New York. Very sick patients are shuttled between nursing homes with weak infection control and top-notch medical institutions that frequently draw patients from across the area.

"We need to improve our monitoring and infection control, particularly in locations where patients are placed in groups," he added. "We should be concerned about Candida Auris, but we must not lose sight of the broader picture since there are many other drug-resistant organisms to be concerned about."

 

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