Candida Auris: All You Need To Know

Candida auris is a fungus that keeps doctors of all walks of life spellbound. Infections caused by this microorganism have been found in different parts of the world, and have the particularity of being resistant to usual treatments. We tell you everything you need to know about this yeast.

Auris Candida is the name given to a mushroom of the family of candida . This fungus has become infamous in the scientific community for its ability to develop resistance to anti-fungals commonly used in clinical practice.

What is Candida auris?

Epidemic outbreaks of this fungus almost always appear in hospitals or in residences for the elderly. In addition, some of them were of great severity, even to the point of causing sepsis, that is, the expansion of the infection in the patient’s blood.

Identifed was this organism for the first time in 2009. There is talk of candida ” auris ” because he was isolated from a sample of the ear canal of a patient native of South Korea. Then, the intra-hospital epidemic outbreaks of candida alerted the scientific community in 2016 and 2017.

The most severe outbreaks have been recorded in intensive therapy units. This has led to extreme precautions being put in place among health personnel to control contagion. However, the second problem lies in the resilience of this fungus.

It is assumed that by appearing in hospital settings, its drug resistance is more marked. Samples taken from hospital floors, clinic bedroom furniture, and even sanatorium computers have tested positive for Candida auris.

Cases of Candida auris worldwide

After confirmation of the first case of Candida auris in 2009, researchers recognized only Previous unidentified infections could be due to this pathogen. In 2008, one particular case was suspected in a South Korean resident.

From there, with established scientific knowledge, cases have been cataloged in India, South Africa, Venezuela, UK, Israel and USA. The latter two countries, along with Spain and Colombia, became aware of the problem in 2016, when many cases were declared.

As for the episodes with interned patients, there were two which are particularly important. The first, at the Royal Brompton hospital in London, in 2015, and the second, in the La Fe hospital in Valence, in 2016. Each epidemic outbreak affected a significant number of people hospitalized.

Risk factors

Not all people exposed to Candida auris get an infection and develop severe symptoms. In addition, it is known that some people are carriers of the fungus and will never develop symptoms. This situation is called colonization, and although it is not synonymous with seriousness for the carrier, these patients become potential transmitters of the fungus to others.

The main risk factor for infection is being hospitalized and connected to an invasive instrument, be it a catheter or a catheter. The other risk factors are:

• Being isolated in a retirement home

• Take anti-fungal medications frequently

• Make frequent visits to the hospital: whether for personal health issues or as an inpatient visitor

Drug resistance of Candida auris

A surprising characteristic of Candida auris is its ability to resist anti-fungal drugs. This is something that worries epidemiologists and infectious disease specialists. Epidemic outbreaks in hospitals put on alert. Indeed, it is not known whether or not it will be difficult to eradicate the fungus that has dispersed.

Almost all varieties of Candida are sensitive to fluconazole. It is common to treat Candida albicans infections  with this medicine. Finally, in the case of Candida auris , resistance to fluconazole is immediate.

Also, resistance has been recorded to other anti-fungals, between these amphotericin B and voriconazole. According to scientific reports, approximately 90% of recorded Candida auris strains are resistant to one class of anti-fungals , while a third of them are resistant to more than two different drugs.

The treatment

So far, a group of special anti-fungals have shown relative effectiveness in eradicating the Candida auris. These drugs are the echinocandins, and the best known are three: anidulafungin , the caspofungin and micafungin.

However, these drugs are not always available, and there have even been strains resistant to them. If this situation arises, it is suggested to use in the affected patient a mixture of anti-fungals. This mixture will be administered in higher doses than usual.

It should also be noted that these patients previously suffered from an illness which required hospitalization. Finally, their immune system is weakened and certain other diseases coexist. The healthcare team must define how to combine the therapies according to each problem.

This critical situation posed by Candida auris reminds us of the need to be careful in the use of drugs. Both patients and physicians should adhere to prescribing guides. This will avoid generating any form of microbial resistance.