Just when you thought antibiotic-resistant bacteria were all that you had to worry about in a hospital, enter antibiotic resistant fungi.
Candida auris in a petri dish.Nicolas Armer / picture alliance via Getty Image file
According to the CDC (Center for Disease Control) Candida auris is an urgent emerging threat due to its antibiotic resistance and fast recent spreading. Since 2016, cases have increased, and by 2023 there were 4500 new clinical cases in the United States.
C auris mostly affects people with risk factors like invasive medical devices (breathing tubes, feeding tubes, tracheostomies, ventilators, catheters, critical care stays, etc.) and long stays in healthcare facilities.
But for those who do get this often resistant organism, it can be serious, and labs that identify C. auris are asked to notify their state or local public health departments. Longer stays in healthcare facilities, use of tracheostomies and percutaneous endoscopic gastrostomy tubes, ventilators in clinical care units and mobile equipment in healthcare settings are shown as major risk factors. [1][2]
What can be done?
One thing that needs done immediately is better identification and tracking. Beyond that, we need new antifungals that can be used to treat this. While Echinocandins are the treatment of choice for C. auris infection, C.auris often shows resistance to azoles and amphotericin B and there are emerging pan-resistant varieties. [5] While there are some antifungals in the pipeline.[3] [5]
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A second thing that can be done, is to continue to search for new antibiotics for fungi. Recall that fungal antibiotics are very different from bacterial antibiotics. We have few of the former, and lots of the latter. Finding effective antifungals that are not toxic is hard, because they are eukaryotes, just like us.
That said, there is some promising research in ocean sponges, cucumbers, and various marine bacteria. More on that in some future blog.
[4] https://doi.org/10.1080/14787210.2017.1364992 Navalkele, B. D., Revankar, S., & Chandrasekar, P. (2017). Candida auris: a worrisome, globally emerging pathogen. Expert Review of Anti-Infective Therapy, 15(9), 819–827. https://doi.org/10.1080/14787210.2017.1364992
[5] Bhagyashri D. Navalkele, Sanjay Revankar & Pranatharthi Chandrasekar(2017): Candida auris: A worrisome, globally emerging pathogen, Expert Review of Anti-infective Therapy, DOI: 10.1080/14787210.2017.1364992
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Super interesting.