Candida auris: the super fungus, what it is, risk group, what the symptoms are and how to prevent it.

What is it?

Candida auris has been a subject of growing concern in the global health arena. It is considered an emerging pathogen.

It is a single-celled fungus belonging to the Candida genus, resistant to drugs, considered to have a high mortality rate in humans and which can cause serious infections in patients with weakened immune systems.

High mortality:

Candida auris represents a significant challenge for healthcare professionals and health authorities worldwide.

The mortality rate associated with this infection is worrying, estimated at around 39%, according to scientific studies. For comparison purposes, according to the Brazilian Ministry of Health, COVID-19 has a mortality rate ranging from 1.9 to 2.8%.

This high rate reinforces the importance of prevention, early detection and appropriate treatment.

Drug resistance

One of the most worrying features is its resistance to currently available antifungal drugs.

This means that traditional treatments may be ineffective against infections caused by this fungus.

The super fungus's resistance to drugs is one of the main reasons why it is considered an emerging pathogen and a global health threat.

Features

Candida auris is a species of fungus that normally lives in:

Skin: may present as reddish, scaly and itchy lesions.

Mouth: can cause whitish or yellowish plaques on the mucous membranes, known as oral candidiasis.

Genitals: may cause itching, redness and abnormal discharge.

It can also live as a normal part of the body's microbial flora without causing problems.

What are the consequences of contracting this fungus?

They can have different consequences, depending on the severity of the infection, the health status of the affected individual and the promptness of appropriate diagnosis and treatment.

Superficial infections: can cause superficial infections of the skin, nails, or mucous membranes, such as in the mouth or genital area. These infections can manifest as lesions, rashes, ulcers, or symptoms similar to candidiasis (a Candida fungal infection).

Invasive infections: In some cases, it can spread to internal organs and cause more serious invasive infections, such as bloodstream infections (candidemia), urinary tract infections, lung infections, or infections of the bones, joints, or heart valves. These invasive infections can be life-threatening and require immediate treatment.

Drug resistance: may develop resistance to certain antifungals, which can make it difficult to effectively treat the infection. This can lead to additional complications and increase the severity of the infection.

Impact on general health: can negatively affect an individual's overall health, especially those with weakened immune systems. This can lead to complications, prolonged recovery time, and an increased risk of other opportunistic infections.

It is important to highlight that each case of infection by this fungus can be unique, and the consequences can vary from person to person.

Symptoms:

The most common symptoms of an infection caused by this super fungus include:

• Fever;
• Excessive sweating (sweating);
• Low blood pressure;
• Chills.

It is important to note that not all infected people present obvious symptoms, making early diagnosis difficult.

How is the fungus transmitted and what is the risk group?

It can be transmitted:

• From person to person through direct contact with contaminated surfaces, such as skin or objects.
• Indirect transmission through contact with respiratory droplets or through contact with the hands of healthcare professionals.
• Transmission can also occur in a hospital setting, where the fungus can easily spread between patients.

Patients hospitalized in intensive care units (ICUs), particularly those who have undergone invasive procedures or have received prolonged use of antibiotics or antifungals, are more susceptible to contamination.

How is Candida auris diagnosed?

The diagnostic process generally involves the following steps:

1. Sample collection: To diagnose Candida auris, samples of tissue, body fluids, or relevant clinical materials such as blood, urine, respiratory secretions, or wound cultures are collected.
2. Isolation in the laboratory: The collected samples are processed in a laboratory, where the Candida auris fungus is isolated through cultures in specific culture media.
3. Accurate identification: After isolation, molecular techniques such as polymerase chain reaction (PCR) and gene sequencing are used to confirm the identity of Candida auris. These techniques are important for distinguishing Candida auris from other Candida species.

Proper diagnosis requires specialized laboratory equipment and techniques, as it can be easily confused with other types of fungi.

Is there a treatment?

Yes! Antifungal medications commonly used to treat Candida auris infections include voriconazole, amphotericin B, and echinocandins such as caspofungin and micafungin.

However, the choice of specific medication may depend on the resistance profile of the fungus and the severity of the infection.

However, resistance to antifungal drugs can make treatment more challenging.

It is important to emphasize that the treatment of Candida auris infections must be individualized and guided by specialized health professionals, such as infectologists or mycologists.

How to prevent?

Prevention involves measures similar to general practices for preventing hospital-acquired infections. Here are some measures that can help reduce the risk of contracting the infection:

Hand hygiene: avoid touching your mouth, eyes and nose with unwashed hands. Wash your hands regularly with soap and water, rubbing them together for at least 20 seconds or use an alcohol-based hand sanitizer with at least 60%.

Hospital hygiene and sharing: If you are hospitalized or accompanying someone, wash your hands before and after entering the room, and wear personal protective equipment, as do healthcare professionals. Avoid sharing medical equipment and devices, especially those that come into contact with the body, such as catheters and probes. These devices should be properly sterilized between uses.

Overuse of antimicrobials: Excessive and inappropriate use of antibiotics and antifungals can increase the risk of infections. It is important to only take medication when prescribed by a healthcare professional and to correctly follow the recommended duration and dosage.

Respiratory hygiene practices: cover your mouth and nose when coughing or sneezing with a disposable tissue or your forearm.

Can Candida auris become a pandemic? Is there a vaccine?

Although it is a global health threat, it is not considered a pandemic agent, as its spread is more common in controlled healthcare settings.

However, continued surveillance and adoption of preventive measures are crucial to avoid outbreaks and minimize the impacts of the fungus.

There is currently no vaccine available to prevent these infections. However, research is ongoing to develop effective immunization strategies against this and other fungal infections.

Awareness, prevention and proper control are essential to reduce the risks associated with the superbug. Through a collaborative approach, we can protect public health.

For more information, visit I am healthy.

Biographical references of the article:

1- Multidrug-resistant Candida auris infections in critically ill patients: risk factors and outcomes. Link: https://wwwnc.cdc.gov/eid/article/26/11/20-3504_article

2- Candida auris emergence: an international call for action. Link: https://pubmed.ncbi.nlm.nih.gov/27989986/

3- Candida auris: a literature review. Link: https://pubmed.ncbi.nlm.nih.gov/29142078/

4- Epidemiology of Candida auris in a hospital in Kuwait. Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712429/

5- Clinical characteristics and risk factors of bloodstream infections by Candida auris. Link: https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/clinical-epidemiology-and-risk-factors-of-candida-auris-bloodstream-infection-in-trauma-patients/3EA73377313B52D55413A9B1EAF818C0

6- Candida auris: an emerging multidrug-resistant pathogen of global significance. Link: https://pubmed.ncbi.nlm.nih.gov/28888662/