The killer germ, a fungus called Candida auris, has showed up in countries as far apart as Australia and Canada, Venezuela and Japan, over the past few years. It has set alarm bells ringing because it is often resistant to multiple anti-fungal drugs.
Candida auris is an emerging fungus that presents a serious global health threat. Patients can remain colonised with C. auris for a long time and C. auris can persist on surfaces in healthcare environments. This can result in spread of C. auris between patients in healthcare facilities.
It is difficult to identify with standard lab methods. It may have had a role to play in the development of its resistance. Healthcare personnel oblivious to it for long continue to prescribe antibiotics — giving the organism time to acclimatise to the medication. C. auris is known to cause outbreaks in hospitals, where it finds vulnerable individuals.
Precautions and Treatment
The key is to prevent the fungus from spreading, so the management of the infection is hinged on 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, and all equipment used for the care of the patient should be cleaned every day in accordance with clinical care recommendations.
Guidelines for treatment say that only when there are symptoms of an infection should the patient be given anti-fungals such as Caspofungin and Micafungin.
Signs and symptoms of C. auris
Symptoms may not be noticeable, because patients infected with C. auris are often patients in the hospital with another serious illness or condition.
Symptoms can vary greatly depending on the part of the body affected and can cause different types of infection such as bloodstream infection, wound infection, and ear infection, etc. Doctors say symptoms can include fever, body aches, and fatigue.
C. auris infection often goes unnoticed and its resistance to drugs makes it even more difficult to treat. Moreover, it is difficult to identify with standard laboratory tests, increasing the risk of mismanagement or misidentification if not diagnosed properly.
As per CDC, more than 90 per cent of C. auris infections are resistant to at least one drug, and 30 per cent are resistant to two or more antibiotics. And other prominent strains of the fungus Candida have not developed significant resistance to drugs, said the CDC. Finding a cure for the infection is now a matter of urgency.
Basically, C. auris can spread in hospitals, targetting people with weakened immune systems.
It can spread from one patient to another in healthcare settings through contact with contaminated environmental surfaces or equipment.
Healthy people usually don’t get infected with the fungus. Yet, more research is required to further understand how it spreads.
Nearly half of patients die within 90 days of being diagnosed with the fungus.
In most cases, patients who have died with C. auris had other serious conditions that increased their risk of death.
Prevention and control measures
Placing the patients with C. auris in single rooms and using Standard and Contact Precautions.
Increasing emphasis on hand hygiene.
Cleaning and disinfecting patient care environment and reusable equipment with recommended products.
Inter-facility communication about patient’s C. auris status – when a patient is being transferred to another healthcare facility.
Conducting surveillance for new cases to detect ongoing transmission.
Screening patients to identify C. auris colonisation is a vital part of infection prevention and control.
Multidrug resistance problem
The increase in resistant organisms is fueled by overuse of antimicrobial drugs, not just in healthcare settings but also in agriculture.
As more microorganisms evolve ways to survive commonly used drugs, treating infections becomes more difficult.
This increases the risks associated with hospitalizations and surgeries.