Doctors in Brazil have reported a ‘rapid rise of drug-resistant Candida auris (C. auris), a potentially fatal fungal infection in a hospital where COVID-19 patients are treated.
Researchers led by Dr Arnaldo Colombo at Federal University in Sao Paulo originally reported in the Journal of Fungi in March 2021 that the fungus ‘remained highly susceptible to antifungal drugs’; however, since then they have detected ‘a steep increase in the resistance of C. auris to fluconazol and a class of anti-fungal drugs called echinocandins in samples from the hospital’.
Dr Colombo’s particular concern is that ‘the species quickly becomes resistant to multiple drugs and isn’t very sensitive to disinfectants used by hospitals and clinics. As a result, it’s able to persist in hospitals, where it colonises health workers and ends up infecting patients with severe COVID-19 and other long-stay critical patients.’ Meanwhile, cases of drug-resistant C. auris have been increasing in the US during the COVID-19 pandemic, noted medicalnewstoday.com.
The Centres for Disease Control and Prevention (CDC) – which warned C. auris can cause infections of the bloodstream, wounds and the ear – said outbreaks ‘may be related to changes in infection control practices, including limited availability of gloves and gowns, or reuse of these items’.
CDC estimated 30-60% of people with C. auris infections die, though many of these patients also had other life threatening illnesses.
Dr Colombo’s paper stated superinfection by C. auris in critically ill patients with COVID-19 ‘is estimated to have a 30-day mortality rate above 50%’.
CDC’s Dr Meghan Marie Lyman confirmed during the COVID-1 pandemic ‘there has been an increase in C. auris cases, particularly in some areas of the US that had not previously had many cases’.
Since 2009 when C. auris was firs identified in Japan, infections have bee reported in more than 30 countries.
While most infections remain susceptible to echinocandins, some strains of the fungus ‘have developed resistance to all three main classes of anti-fungal drug’.
Dr Lyman warned: ‘Reports of echinocandin or pan-resistance C. auris cases in the US are increasing, which is concerning because antifungal treatment options for these highly resistant infections are extremely limited.’
