A deadly infectious fungal disease that is resistant to many drugs has 鈥渋nfested鈥� New York and affected more than 600 people in the city, in the biggest outbreak in the US so far.
Candida auris聽is a type of yeast. Between August 2016 and 2018, nearly 60 hospitals and more than 90 nursing homes in New York City were affected by the microbe. Worryingly, the fungus proved resistant to all three major anti-fungal drugs, with a 99 per cent resistance in the case of one medication, Fluconazole.
The fungus, which can be deadly for people with underlying health conditions, has spread to healthcare systems on five continents since emerging ten years ago. It was first found in the ear of a Japanese patient 鈥� hence the auris name. Although it spreads easily and rapidly via surfaces and people, researchers still do not know exactly how, and its ultimate origin has yet to be found.
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鈥淚t鈥檚 quite a big problem, because of the way it is spreading and the way it lives in your body parts, and its ability to shed,鈥� says Sudha Chaturvedi of the New York State Department of Health, who undertook the research. 鈥淣ew York City is infested, especially Brooklyn and Queens,鈥� she says. The big concern with C. auris, she adds, is its resistance to multiple drugs.
Resistant to all drugs
Of the people affected during the New York outbreak, 277 were infected and 350 had been colonised by the microbe, meaning they are a carrier but do not have symptoms. Of particular concern were two patients who had a strain of the fungus that was resistant to all drugs used to fight it.
A major challenge to stopping further spread is the difficulty in detecting the fungus. 鈥淚t鈥檚 a unique bug, it cannot be identified by a simple biochemical test,鈥� says Chaturvedi, who presented her research at the ASM Microbe conference in San Francisco last week. There are only around ten labs in the US that can test for it, she says.
People shedding the fungus on hospital beds appear to offer a key way for it to spread, according to new research by Joseph Sexton of US health agency, Centers for Disease Control and Prevention. Concentrations on the skin of colonised patients at a Chicago facility were found to correlated with concentrations on beds. Sexton says while the mechanism for spreading 鈥渕akes intuitive sense鈥�, it is important to have the data, which suggests greater disinfection of beds is needed.
West coast infections
While the fungus has spread from the US east coast in 2013 , it seems to be on the wane in England. Health watchdog Public Health England says that between 2013 and March 2019, 266 patients were colonised or infected with C. auris 鈥�聽but the number of detections has fallen each year since 2016.
鈥淲e seem to have everything under control here in the UK now,鈥� says Johanna Rhodes at Imperial College London. 鈥淲e know how to disinfect the environment now, and how to limit the spread via the movement of patients.鈥� She fears the fungus could quickly develop resistance to new drugs coming down the line because they are derivatives of existing ones. 鈥淲e need an entirely new class of antifungal drugs.鈥�
