Candida auris spreads rapidly in the United States, and the death rate is alarming! How can we prevent it? Expert explanation

Text/Chen Haoxing

A rare fungus spreads in the United States. According to a communiqué issued by the US Centers for Disease Control and Prevention (CDC), the number of Candida auris infections in the United States continues to rise every year, spreading at an alarming rate. The pathogen is resistant to many antifungal drugs and has become an urgent public health threat.

What disease is Candida auris? How contagious and lethal? What are the differences from other infectious diseases?

Is it true or false that Candida auris has a high mortality rate?

Candida auris is a newly discovered yeast in recent years, called Candida auris because it was first discovered from the external auditory canal. It was first discovered in Japan in 2009. In recent years, infections have been reported in more than 30 countries around the world.

According to the U.S. Centers for Disease Control and Prevention, nearly half of patients infected with Candida auris die within 90 days, and an estimated 30 to 70 percent of infected hospitalized patients eventually die.

Although Candida auris is currently only spreading rapidly in the United States, we also need to know something about this "deadly fungus".

Li Tong, chief physician of the Department of Infectious Diseases of Beijing You'an Hospital affiliated to Capital Medical University, once said in an interview with Guois Express that Candida auris is an infectious disease, which is actually not the same as infectious diseases. Infectious diseases are mainly human-to-human transmission in society, and Candida auris is a pathogen that enters the human body and causes people to get sick, not an infectious disease in the true sense.

In Li Tongzeng's view, the high mortality rate of Candida auris is caused by many factors, mainly in three aspects:

First, Candida auris is highly resistant, and the existing antifungal drugs have poor effect against Candida auris;

Second, the infection of Candida auris is not easy to detect by medical staff;

Third, Candida auris mainly threatens critically ill patients and immunocompromised groups, and the high mortality rate is also related to other complications of critically ill patients.

Who and by which route can be infected with Candida auris?

Many medical experts believe that at present, Candida auris is mainly a nosocomial infection, and critically ill patients, critically ill patients and immunocompromised people in the intensive care unit are at greatest risk, and people without chronic diseases and healthy people do not need to panic excessively.

"The spread of Candida auris is more about not paying attention to hand hygiene, and medical equipment, intensive care units, general wards, etc. are not strictly disinfected, resulting in the surface of objects attaching to this fungus. In particular, when medical personnel perform medical procedures, it causes infection in hospitalized patients. Li Tong once said.

The large-scale infection in the United States may be because Candida auris is not easy to be detected by medical staff, coupled with the limited testing level of some medical institutions, misdiagnosis and missed diagnosis. At the same time, due to supply shortages during the pandemic, protective equipment is often reused, which also accelerates the spread of fungi.

Li Tong also reminded that the infection of Candida auris is related to the widespread use of antibiotics, including the abuse of antifungal drugs and antibacterial drugs. Standardizing the use and avoiding the misuse of antibiotics can reduce the development of this resistant bacterium and further reduce the risk of Candida auris infection.

How can I prevent Candida auris infection?

As early as 2018, Candida auris was detected in the alveolar lavage fluid of a patient with nephrotic syndrome in Peking University People's Hospital, which was the first case of Candida auris infection in China. As of August 2020, 8 cases of Candida auris infection have been reported publicly reported in China.

How is Candida auris treated once detected?

Li Tong once introduced that after detecting Candida auris, it is necessary to find the source of the infection as soon as possible. Because they are generally hospitalized patients, it is necessary to timely sample and test the patient's ward, the medical staff that the patient has contacted, especially the hands, or the medical equipment and the environment of the ward. After the test is found, the relevant equipment, personnel, and wards must be thoroughly disinfected to achieve timely prevention effects.

Li Tong once said that if the doctor determines that it is Candida auris infection, antifungal treatment can be performed. After detecting this fungus, a resistance test can also be done to see if effective antifungal drugs can be found among existing antifungal drugs. Candida auris is easily resistant, but it is not necessarily resistant to all existing drugs, and if effective antifungal drugs can be found, it can still be cured.

At the same time, experts from relevant departments remind that "for people who have returned to China after entering the 'epidemic area', before and after returning to China, they must carefully wash their bodies and clothes, and disinfect them, and do not contact people with immunodeficiency and low immunity." ”

At present, the occurrence of Candida auris in China is still a case, and there are no concentrated outbreak cases, so there is no need to worry too much about the threat posed by Candida auris.