Deadly, Drug-Resistant Infection Showing up Around the United States
A drug-resistant germ that has hit the U.S. is being called a “creature from the black lagoon” by a CDC official who worries about its impact on frail Americans.
With an ever-increasing load of cases, the federal Centers for Disease Control has declared, “Candida auris is an emerging fungus that presents a serious global health threat.”
One of its top officials put the stakes in layman’s language.
“It is a creature from the black lagoon. It bubbled up and now it is everywhere.” Dr. Tom Chiller, who heads the CDC’s mycotic diseases branch, said.
The fungus can “persist on surfaces in healthcare environments. This can result in spread of C. auris between patients in healthcare facilities,” the CDC warned.
Most cases in America “have been detected in the New York City area, New Jersey, and the Chicago area,” the CDC said, though cases have been reported in Texas, Oklahoma, California, Florida, Virginia, Maryland, Indiana, Massachusetts and Connecticut. The CDC said that as of February, 617 confirmed or probable cases of the fungus have been reported in the U.S.
“We’re very alarmed because some strains of C. auris in other countries are resistant to all three major classes of antifungal drugs, which we’ve never seen before,” Chiller said, according to Consumer Reports. “We’re taking as proactive and aggressive an approach as possible to try to keep it in check in the United States.”
Candida auris is a fungal infection that does not respond to antifungal medications, posing the same problem that excessive use of antibiotics has created in the growth and spread of anti-bacterial resistance. This is a looming threat to public health. https://t.co/o7ugWdQeNk
— nalini visvanathan (@nalinivisvanath) April 6, 2019
The fungus attacks those who are weakest.
“We haven’t seen it in the general community. It’s mainly a hospital-acquired infection,” said Dr. Peter Pappas, a professor of medicine at the University of Alabama and spokesman for the Infectious Diseases Society of America.
Chiller said C. auris has hit “the sickest of the sick — people who are in and out of ICUs and also have central lines or immune-system-lowering conditions such as diabetes.” Central lines are the intravenous tubes connected to provide patients with medication and fluids.
Cases of the fungus in America “are a result of inadvertent introduction into the United States from a patient who recently received healthcare in a country where C. auris has been reported or a result of local spread after such an introduction,” the CDC said.
A recent case at New York City’s Mount Sinai Hospital left hospital officials concerned because after the patient who suffered from the fungus died, they faced a totally unexpected problem, The New York Times reported. The fungus had spread throughout the room.
“Everything was positive — the walls, the bed, the doors, the curtains, the phones, the sink, the whiteboard, the poles, the pump,” said Dr. Scott Lorin, the hospital’s president. “The mattress, the bed rails, the canister holes, the window shades, the ceiling, everything in the room was positive.”
The drug-resistant fungus has wreaked havoc abroad. A neonatal unit in Venezuela has hit hard; and a British medical center closed its intensive care unit after the fungus invaded. The fungus has struck in Spain, South Africa, India and Pakistan as well. In the Spanish outbreak, 41 percent of those infected died within 30 days.
The CDC has estimated that overall, roughly half of those infected die within 90 days.
Candida auris is the leading story in NYT today: good to see extensive media coverage of antimicrobial resistant organisms, the most serious and quiet global public health threat we face https://t.co/U4jyWmwtIl via @nytimes
— Mark Downing (@MarkADowning) April 6, 2019
The fungus is feared because nothing in the current arsenal of drugs used to treat such diseases can kill it.
“It’s an enormous problem. We depend on being able to treat those patients with antifungals,” Matthew Fisher, a professor of fungal epidemiology at Imperial College London, said.
C. auris is the top threat among resistant infections, Dr. Lynn Sosa, Connecticut’s deputy state epidemiologist, said.
“It’s pretty much unbeatable and difficult to identity,” she said.
Some link the rise of drug-resistant bacteria and fungi to the use of pesticides.
Interestingly, multi drug resistant Candida Auris appears to have arisen as a result of anti-fungal pesticides used for commercial agriculture. As we apply more pressure on #anthropocene era planet ? you can expect more and more of these resistant bugs to arise. 2/ pic.twitter.com/7q6JfKlW6X
— Jake Kushner MD (@JakeKushnerMD) April 6, 2019
Outbreaks are often kept quiet by hospitals that do not want to be seen as centers of infection. That frustrates those who want the public informed. In the case of Royal Brompton Hospital in London, the initial 2015 outbreak was kept under wraps for months.
“Why the heck are we reading about an outbreak almost a year and a half later — and not have it front-page news the day after it happens?” Dr. Kevin Kavanagh of Kentucky, who chairs the patient advocacy group Health Watch USA, said. “You wouldn’t tolerate this at a restaurant with a food poisoning outbreak.”
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