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Deadly yeast – why Candida auris is so dangerous



Image: imago / watson montage

Deadly Yeast – Why Candida auris it's so dangerous

Daniel Huber / watson.ch

Unstoppable, it seems, it's spreading: Candida auris, a yeast fungus, infects people in more and more countries around the world. For many of them the infestation ends fatally – Candida auris is a multi-drug resistant fungus that can cause invasive infections. And, unlike other species previously known, it is transmitted from the patient to the patient and onto contaminated surfaces. This makes him the terror of hospitals, which are only having difficulty mastering an outbreak of the pathogen.

Yeast fungus was first found in the ear secretion of a Japanese patient in 2009 – hence the addition of the name auris (Latin for "the relative ear"). Since then, there have been infections in many countries, from South Korea to India and Kenya to Canada.

In Europe, the pathogen has already consolidated – especially in Spain and the United Kingdom. In London, the first major outbreak occurred in 2015 and 72 patients were infected. The only case in Switzerland to date has involved an elderly patient who had been infected in Spain and died in October 2017 at a Geneva hospital.

Allow: Candida auris

Mushroom can look so beautiful – just a matter of perspective. Image: imago stock & people

From 2013 to 2017, a total of 620 cases were reported in Europe, according to the European Center for Disease Prevention and Control (ECDC), with a significant increase in 2016 and 2017. Most reports were in Spain (388 cases ) and in Great Britain (221 cases). About three-quarters of all reported cases were a harmless colonization of the body with the fungus, but the rest of the patients had blood poisoning or other infections.

Weakened immune system

The reason for this is usually a weakened immune system, for example, in patients with chronic diseases, cancer or AIDS. Other yeasts colonize the skin or mucous membranes of humans – Candida albicans For example, a fairly harmless fungus that usually does not cause problems. In congenital or acquired immunodeficiency, it may be Candida albicans but multiply so much that it leads to a so-called candidosis (also known as "thrush").

This is how it is Candida auris For a healthy immune system, there is usually no serious threat. In fact, healthy people who are infected with the fungus do not have symptoms and spread it without their knowledge. Only a laboratory test can tell if someone is Candida auris is filled in. But if pre-existing conditions, yeast can enter the bloodstream and there is sepsis – a cause of blood poisoning. It can also infect wounds or urinary and respiratory tracts and cause dangerous infections there.

In contrast to his more harmless relatives he ends up Candida auris in such cases as a true killer. The Centers for Disease Control and Prevention (CDC) estimates that up to 30 to 60 percent of all infections in which the fungus enters the body are fatal. For the first time in August 2017, the agency issued a warning of a serious global threat.

Multidrug resistant pathogen

Besides that, Candida auris it is not always so easy to identify, but most of all, that many of its fungal strains are resistant to one or more of the medicines used to fight fungal infections. In 90% of infections caused by the fungus, at least one drug does not work, in 30% of infections there are up to two or more drugs.

Such resistances are otherwise known from bacteria – hence it is well known that, for example, less and less antibiotics are effective against multidrug resistant tuberculosis pathogens. On the other hand, one hardly thinks of mushrooms. Even with antibiotic resistance, however, it is important that people with weakened immune systems are at risk, including newborns, the elderly, diabetics, and people who need to take immunosuppressants.

The problem of multiresistant germs is exacerbated by inappropriate use of antibiotics. If it is not possible to reduce the abuse of these important medicines and at the same time develop new drugs for multi-drug resistant bacteria, the risk will increase over time, even for healthier people, who are even less at risk. According to a WHO estimate, multiresistant pathogens could cause more deaths by 2050 than cancer.

"Antibiotic-resistant germs explained in 3 minutes." Video: YouTube / youknow

Persistent Mushroom

Mushrooms as Candida auris, which are resistant to antifungals (antifungals), exacerbate this problem. Yeast fungus is also extremely resistant: it is a biofilm on the surface of furniture and medical devices and it is difficult to get away from there. As an elderly patient who is infected with Candida auris When Litt was admitted to a hospital in the Brooklyn borough of New York in May 2018, doctors discovered after his death that the fungus had infested the entire room – walls, ceiling, floor. Parts of the ceiling and floor had to be ripped and discarded.

For hospitals, this is a nightmare. The fungus can thus be transferred not only from patient to patient, but also through contaminated rooms and equipment. After all, according to the current state of knowledge, transmission does not occur via air as with many cold viruses, but only as a smear infection.

Doctors recognized the danger of yeast. In Switzerland, infectologists created the Funginos (Swiss Fungi Infection Network) research platform in 2002, which now also deals with cases of auris CandidaInfections The Swissnoso association, which fights hospital infections, has the mushroom in sight. When patients are repatriated from abroad to Switzerland, they are isolated for the first time until they are sure they no longer have multi-drug resistant agents – also Candida auris do not.

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