Hygiene at frontline of fight against deadly new 'superfungus'
The global spread of candida auris – a deadly superfungus that’s difficult to diagnose – is shining a spotlight on the urgent need to develop new medicines capable of killing drug-resistant germs.
Impervious to both antiseptics and the three major classes of anti-fungal medications, candida auris has been quietly transmitted within hospitals and nursing homes in at least 15 countries since it was first identified in 2009 – leading the US Centre for Disease Control to declare it a "serious global threat”.
Even though the majority of people infected worldwide have died – usually within 90 days – there’s no need to panic, says Sascha Brunke, who researches fungal disease and resistance at the Hans-Knöll-Institut in Jena, Germany.
With candida auris, we know there should be a reservoir in the environment somewhere, but we don’t know what it is.
“This is only dangerous to a specific group of people – people who are already sick. So while it’s tragic on an individual level, it’s not a huge global threat.”
Brunke does concede that candida auris is unusually resistant to many anti-fungals – and “that’s something we should worry about” – but he says it should be seen more as a symptom of the greater problem of antimicrobial resistance.
Because the pathogen infects people who have already-weakened immune systems (this includes babies and the elderly), and who are suffering other underlying conditions, doctors warn it’s hard to be really sure if a person’s death is a result of the fungus, or something else.
Outbreaks of the #fungal #pathogen #Candida #auris in #healthcare settings, particularly in intensive care units (ICUs), may be linked to multi-use patient equipment, such as thermometers, according to new research. #clinical #microbiology pic.twitter.com/hOSyWwKc08Clinical Microbiology (@CMicrobiology) 16 janvier 2019
“It’s important to note that we have no idea where candida auris has come from,” says Johanna Rhodes an expert in infectious diseases at Imperial College London. “All pathogens that infect humans and animals have what’s called a reservoir in the environment. Ebola has a reservoir in bats. It doesn’t kill the bats but it spills over into humans and causes an infection.
“With candida auris, we know there should be a reservoir in the environment somewhere, but we don’t know what it is.”
What we do know is that not only is candida auris tough to diagnose and very tough to treat, it can also survive on contaminated surfaces – hospital beds, furniture, medical equipment – for extended periods of time. This means it can be spread from person to person indirectly.
In 2015 the fungus forced the temporary closure of a medical facility in London while last year in New York, the room belonging to an elderly man who died of candida auris needed to be entirely gutted.
“Everything was positive – the walls, the bed, the doors, the curtains, the phones, the sink, the whiteboard, the poles, the pump,” Dr Scott Lorin, the hospital’s president, told The New York Times.
While candida auris first came to light in Japan in 2009, it’s been around for longer. “Looking back through collections, we’ve actually been able to isolate it back into the 1990s as it’s been misidentified as other types of candida,” says Rhodes, whose work these days includes helping to correctly identify candida auris so as to improve its diagnosis.
This is only dangerous to a specific group of people – people who are already sick. So while it’s tragic on an individual level, it’s not a huge global threat.
“When we had the outbreak in London, we knew it was another candida, but we didn’t know it was candida auris – so we’ve had to make our own custom databases for identifying it.”
Researchers are pushing for grant money that will fund the development of novel drugs that can kill both superbugs and now, superfungi. It’s a process that can take many years and in the meantime, the frontline in the fight against antimicrobial resistance is hygiene, says Brunke.
“Keeping a sufficient degree of basic hygiene in hospital can greatly reduce transmission. Many hospitals are now aware of this potential threat, and good hygiene is still the best solution.”
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