Explainer | Deadly, drug-resistant fungus is spreading quickly in U.S. — here’s what we know

OTTAWA—A deadly fungus is spreading at an alarming rate in the U.S. and poses a serious health threat across the world, including Canada, according to the American Center for Disease Control and Prevention (CDC).

The transmission of the deadly fungus called Candida auris have risen in U.S. health-care facilities in recent years, with a dramatic increase in 2021, according to recent CDC data published in the Annals of Internal Medicine.

“The rapid rise and geographic spread of cases is concerning and emphasizes the need for continued surveillance, expanded lab capacity, quicker diagnostic tests, and adherence to proven infection prevention and control,” said CDC epidemiologist Dr. Meghan Lyman, lead author of the paper.

2021 saw a tripling in the number of cases resistant to echinocandins, a widespread antibiotic used to treat it, causing further concern amongst scientists. The fungus has become resistant to multiple antifungal drugs used to treat the Candida-type infections, according to recent data.

Infection caused by the fungus has been known to lead to severe illness in hospitalized patients, and can be deadly in some cases.

The CDC also pointed out that the disease has caused outbreaks in health care before, so hospitals need to identify cases of the fungus as soon as possible, to stop its spread.

What is Candida auris?

Candida auris is a fungus that grows as yeast, that can cause dangerous infections that can be life-threatening when it enters the bloodstream. Some symptoms include fever, aches and fatigue, and it can cause blood, wound and ear infections. It also has been detected in respiratory and urine samples, according to the CDC, but it is unclear if it causes infections in the lung or bladder.

Around 400,000 bloodstream infections occur every year due to Candida yeasts, of which Candida auris is a type, and over 40 per cent of these infections are fatal, according to scientists.

How does it spread?

The yeast can enter the bloodstream and from there spread throughout the body, causing serious invasive infections in immunocompromised patients, according to the CDC.

That said, healthy people rarely experience symptoms after contracting it. The CDC describes Candida auris’ ability to live in patients’ bodies even when they don’t feel sick as “colonization.”

The fungus can spread from the bodies of colonized individuals — such as health-care workers — and infect others or contaminate nearby objects.

The yeast can also be resistant to some ammonia-based hospital disinfectants according to Canada Public Health.

Who is at risk?

Patients of any age can be affected, according to the CDC, but people with compromised or weakened immune systems are more vulnerable to it.

Those who have been hospitalized in a health-care facility for a long time, have a central venous catheter or other lines or tubes entering their body, or have previously received antibiotics or antifungal medications appear to be at highest risk of infection.

Nonhospitalized people with lines and tubes that go into their body are also at risk, if they have recently spent time in nursing homes. Other risk factors include recent surgery, diabetes, long-term use of antibiotics and antifungal medication.

Healthy people don’t have much cause for concern, according to The American Council on Science and Health, but should take precautions and wash their hands frequently if a loved one is colonized or infected.

How is it diagnosed?

It is difficult to identify the fungus using standard laboratory methods, and it can be misidentified by labs without specific technology, according to the CDC.

Infections caused by Candida auris are usually diagnosed by blood culture or other body fluids. However, this specific yeast is harder to identify from cultures than other common Candida yeasts, and can be confused with other types.

How to treat it?

Patients suspected or confirmed to have the infection should be cared for with gowns and gloves in a private room with a private washroom.

Scientists warn we need to stop the unnecessary use of antibiotics to reduce the risk of wider spread.

The ground zero

Candida auris was first identified in Japan in 2009 in the ear discharge of a female patient, and it has spread over six continents and 30 countries since then, according to the CDC. The first case in the U.S. was detected in 2016.

What does it mean for Canada?

Since 2012, there have been 43 known cases of Candida auris in Canada, including both infected and colonized cases. Some of these cases were associated with travel and did not originate here, according to Health Canada.

“The risk to the general population at this time is considered very low,” Tammy Jarbeau, Health Canada spokesperson, told the Star.

“Globally, outbreaks of C. auris have been limited to health-care settings, as opposed to the community. Similar to the experience of other countries, it is possible that Candida auris will become more common in Canada, including the potential for outbreaks in health-care and long-term care facilities,” she said.

All known cases in Canada so far have been susceptible to the recommended treatment, according to Health Canada.

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