Context

• US Centers for Disease Control and Prevention has reported that a drug-resistant superbug fungus- Candida Auris has sickened nearly 600 people across the United States, including more than 300 patients in New York State.
• Recently, a top American hospital had to rip out ceiling and floor tiles to get rid of the infestation from this fungus in the room of the effected patient after his death.

About

What is Candida Auris?

It is a fungus that causes serious bloodstream infections and even death, particularly in hospital and nursing home patients. It preys on people with weakened immune systems. More than 1 in 3 patients with invasive C. Auris infection (for example, an infection that affects the blood, heart, or brain) die.

Why it is a problem

• Resistant to multiple anti-fungal drugs: Antifungal medicines commonly used to treat Candida infections often don’t work for it. Some C. auris infections have been resistant to all three types of antifungal medicines.
• Difficult to identify: auris can be misidentified as other types of fungi unless specialized laboratory technology is used. This misidentification might lead to a patient getting the wrong treatment hence giving time to the fungus to acclimatise to the medication.
• It can spread in hospitals and nursing homes. C. auris has caused outbreaks in healthcare facilities and can spread through contact with affected patients and contaminated surfaces or equipment. Good hand hygiene and cleaning in healthcare facilities is important because C. auris can live on surfaces for several weeks.

What are the symptoms of infection?

• People who get invasive Candida infections are often already sick from other medical conditions, so it can be difficult to know if the patient has a C. auris infection.
• The most common symptoms of invasive Candida infection are fever and chills that don’t improve after antibiotic treatment for a suspected bacterial infection.
• Only a laboratory test can diagnose C. auris infection.

What are the precautions and treatment?

• Isolation of the patient, ideally in a single room, with strict hand hygiene. Everyone who has come in contact with a patient should be screened for the fungus. All equipment used for the care of the patient should be cleaned every day in accordance with clinical care recommendations.
• Only when there are symptoms of an infection should the patient be given anti-fungals such as Caspofungin and Micafungin.

Brief history of Candida Auris fungus:

• It has been around for at least a decade. It was identified in 2009 from yeast isolates from the ear of a Japanese patient, and described as a new species after RNA sequencing.
• In 2013, a team of Indian scientists led by those from the Vallabhbhai Patel Chest Institute, Delhi, documented in Emerging Infectious Diseases “the emergence of a new clonal strain of C. auris as an etiologic agent of candidemia in India”.
• In 2017, the same team of researchers predicted that going by the behaviour of other similar organisms that have developed resistance, a Candida outbreak might be on the cards.