Article about drug resistant fungus Candida auris

[PatJ]

From the New York Times: A Mysterious Infection, Spanning the Globe in a Climate of Secrecy

The article takes a sensational tone in places but it's still interesting to learn about C. auris, possible reasons for its spreading, and the reactions of health care organizations.

Quotes from the article:

C. auris is so tenacious, in part, because it is impervious to major antifungal medications, making it a new example of one of the world’s most intractable health threats: the rise of drug-resistant infections.

With bacteria and fungi alike, hospitals and local governments are reluctant to disclose outbreaks for fear of being seen as infection hubs. Even the C.D.C., under its agreement with states, is not allowed to make public the location or name of hospitals involved in outbreaks. State governments have in many cases declined to publicly share information beyond acknowledging that they have had cases.

All the while, the germs are easily spread — carried on hands and equipment inside hospitals; ferried on meat and manure-fertilized vegetables from farms; transported across borders by travelers and on exports and imports; and transferred by patients from nursing home to hospital and back.

Nearly half of patients who contract C. auris die within 90 days, according to the C.D.C.

In late 2015, Dr. Johanna Rhodes, an infectious disease expert at Imperial College London, got a panicked call from the Royal Brompton Hospital, a British medical center outside London. C. auris had taken root there months earlier, and the hospital couldn’t clear it.

“‘We have no idea where it’s coming from. We’ve never heard of it. It’s just spread like wildfire,’” Dr. Rhodes said she was told. She agreed to help the hospital identify the fungus’s genetic profile and clean it from rooms.

Under her direction, hospital workers used a special device to spray aerosolized hydrogen peroxide around a room used for a patient with C. auris, the theory being that the vapor would scour each nook and cranny. They left the device going for a week. Then they put a “settle plate” in the middle of the room with a gel at the bottom that would serve as a place for any surviving microbes to grow, Dr. Rhodes said.

Only one organism grew back. C. auris.

@Hip

 

[Hip]

The CDC seems to have an informative page on Candida auris. It says:

Based on information from a limited number of patients, 30–60% of people with C. auris infections have died. However, many of these people had other serious illnesses that also increased their risk of death.

 

[Hope4]

A quick search at duckduckgo search engine, showed this short blog post at Clinell.com about UV light being usedhttp://clinell.com/2018/02/07/uv-light-vs-candida-auris/.

A US study has found that Candida auris exhibited a similar level of susceptibility to UV light as Clostridium difficile spores, and was considerably less susceptible than MRSA. These findings suggest that either extended exposure UV cycles or hydrogen peroxide based room disinfection are required to address environmental contamination with Candida auris.
We have posted before on the efficacy of various disinfectants against Candida auris, supporting that chlorine-based disinfectants and chlorhexidine have a role to play in preventing the transmission of Candida species. This latest laboratory study tested the efficacy of a UV room decontamination system against various species of Candida auris and Candida albicans, MRSA, and C. difficile spores. Metal discs with these organisms dried onto them were placed 5 feet from the device at a height of 4 feet with exposure times of 10, 20, or 30 minutes. UV achieved a <2-log reduction on C. auris after 10 minutes of exposure (vs. a >6-log reduction for MRSA), a 4-log reduction after 20 minutes, and a 6-log reduction after 30 minutes. The efficacy profile of UV against C. difficile and C. auris was similar.
This study is in line with the findings of others that C. auris is able to less susceptible to disinfection than other agents. Therefore, extended exposure UV cycles or hydrogen peroxide based room disinfection should be used to tackle environmental contamination with C. auris.

Link to the referenced study at pubmed. Only the abstract is available.

Here, ozone used to kill the candida c. auris in a sink drain.
This seems to be a study used in testing an ozone-generating sink drain.

The results:

Results
o On steel discs, MRSA, Pseudomonas, and C. auris were reduced by ≥3 log10 colony-forming units (CFUs) with 10 minutes of exposure to ozonated water
o In the sink model, we demonstrated total elimination of C. auris and Pseudomonas sp at the strainer within 2 days of ozone activity (figure 1, 2)
o We also demonstrated total elimination of both organisms at the trap within 9 days of ozone activity (figure 1, 2)
o Beyond the trap there was no significant decolonization (figure 1, 2)

Not many results show in the duckduckgo search for UV light or ozone being used to kill "bugs".

I don't have time or energy to do more looking. But those two examples, even if they are weak ones, show that there are answers to the "new bugs" being reported on.

 

[IThinkImTurningJapanese]

The article takes a sensational tone in places but it's still interesting to learn about C. auris, possible reasons for its spreading,

C. Auris has been with us for ages, without problems.

It proved resistant to a front-line antifungal treatment called itraconazole. That drug is a virtual copy of the azole pesticides that are used to dust crops the world over and account for more than one-third of all fungicide sales.

 

[PatJ]

C. Auris has been with us for ages, without problems.

It's the new drug resistant strains that are getting better at killing people since those strains are now resistant to the three major classes of antifungal drugs.

Considering the relatively small number of cases so far it isn't a major problem at the moment, but has the potential to become one.

There is a related article on the topic from the same reporter.

 

[IThinkImTurningJapanese]

It's the new drug resistant strains that are getting better at killing people since those strains are now resistant to the three major classes of antifungal drugs.

Exactly, and it looks like our experience with antibiotic-resistant bacteria has lead to early recognition of the cause.

Much like we have had to change livestock handling practices (the EU has banned antibiotics as a growth stimulate in livestock) and limit the overuse of antibiotics, we will have to curtail the prophylactic use of fungicides in agriculture.

Or else.