Candida Auris — A Mysterious And Fatal Yeast
November 5, 2019 at 9:59 p.m.
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Not enough has been done to reduce the problem and few new antibiotics have been developed and approved for sale. Those that are available may be unsupported because of their cost.
There is another danger lurking as well, it concerns resistance to yeast or fungi. (Yeasts are a type of fungi.)
One example is Candida albicans, that preys on people with weakened immune systems, and it is quietly spreading and virulently affecting severely ill patients in nursing homes in the United States and across the globe.
Yeasts and fungi are much different than bacteria. They are multicellular, eukaryotic organisms, while bacteria are single-celled prokaryotes. The cells of fungi and yeasts have nuclei that contain the chromosomes and other organelles, such as mitochondria and ribosomes. Bacteria are much smaller than either yeast or fungi, do not have nuclei or other organelles and cannot reproduce sexually.
David Gruby, a Hungarian physician, is generally recognized as the discoverer of fungi that produce diseases. He built an excellent microscope in the early 1840s and began a study of the pathology of body fluids. His attempt at microscopic differentiation of pus from other pathological substances, like mucus or sputum, was a careful, original investigation in a new field of medicine.
In 1841, Gruby subsequently found a fungus in favus, a contagious skin disease situated in hair follicles, and shortly thereafter discovered C. albicans (then Oidium albicans) the cause of thrush in children. His work was recognized in the New England Journal’s 200th Anniversary issue.
In 1923 Christine Marie Berkhout named what we now call Candida albicans, for the white robe, toga candida, worn by Roman senators and senatorial candidates. Albicans also comes from Latin, albicare meaning “to whiten.” A number of Candida species have been discovered through the years.
Now in addition to C. Albicans and others, there is new fungus to worry about and it could be even more deadly. The organism, C. auris (the latin name for ear), is a species reported in Asia as a rare cause of ear infections in 2009; it had not been found among large repositories of samples collected prior to 2013. Retrospective review of Candida strain collections found that the earliest known strain of C. auris dates back to 1996 in South Korea.)
Its virulence is particularly life threatening because bacterial resistance to antibiotics now includes a worldwide emergence of similar development for drugs used to treat fungal diseases.
The inability to control these infections presents a grave risk for both human and animal health. Like C. albicans, C. auris preys on people with weakened immune systems, and it is quietly spreading across the globe.
According to the New York Times, over the past five years it was found in a neonatal unit in Venezuela, swept through a hospital in Spain, forced a prestigious British medical center to shut down its intensive care unit, and taken root in India, Pakistan and South Africa. Cases of C. auris have been identified in 33 countries across five continents.
Recently, C. auris reached New York, New Jersey and Illinois and at least nine other states, leading the federal Centers for Disease Control and Prevention (CDC) to deem it an emerging threat. The outbreaks in the New York area have involved four different varieties, suggesting that the strains were introduced from other countries seeking medical care. Once the organism is introduced into a facility, transmission of single C. auris strains is efficiently spread from patient to patient.
The CDC is concerned about C. auris for three main reasons: 1. It is often multi-drug resistant, 2. It is difficult to identify with standard laboratory methods, and can be misidentified in labs without specific technology, and 3. It has caused outbreaks in healthcare settings.
C. auris has caused bloodstream, ear and wound infections. It also has been isolated from respiratory and urine specimens, but it is unclear if it causes infections in the lung or bladder.
In the U.S., 725 confirmed and 30 probable cases of C. auris have been reported as of June 30, and 1,474 patients have been found to be colonized with the fungus as of July 12.
As mentioned above, C. auris often does not respond to commonly used antifungal drugs, making infections very difficult to treat. Patients who have been hospitalized in a healthcare 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 drugs, appear to be at highest risk of infection.
Final thoughts
The Centers for Disease Control and Prevention maintains a web page with general information about Candida Auris together with a Fact Sheet that can be downloaded.
Max Sherman is a medical writer and pharmacist retired from the medical device industry. He has taught college courses on regulatory and compliance issues at Ivy Tech, Grace College and Butler University. Sherman has an unquenchable thirst for knowledge on all levels. Eclectic Science, the title of his column, touches on famed doctors and scientists, human senses, aging, various diseases, and little-known facts about many species, including their contributions to scientific research. He can be reached by email at [email protected].
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Not enough has been done to reduce the problem and few new antibiotics have been developed and approved for sale. Those that are available may be unsupported because of their cost.
There is another danger lurking as well, it concerns resistance to yeast or fungi. (Yeasts are a type of fungi.)
One example is Candida albicans, that preys on people with weakened immune systems, and it is quietly spreading and virulently affecting severely ill patients in nursing homes in the United States and across the globe.
Yeasts and fungi are much different than bacteria. They are multicellular, eukaryotic organisms, while bacteria are single-celled prokaryotes. The cells of fungi and yeasts have nuclei that contain the chromosomes and other organelles, such as mitochondria and ribosomes. Bacteria are much smaller than either yeast or fungi, do not have nuclei or other organelles and cannot reproduce sexually.
David Gruby, a Hungarian physician, is generally recognized as the discoverer of fungi that produce diseases. He built an excellent microscope in the early 1840s and began a study of the pathology of body fluids. His attempt at microscopic differentiation of pus from other pathological substances, like mucus or sputum, was a careful, original investigation in a new field of medicine.
In 1841, Gruby subsequently found a fungus in favus, a contagious skin disease situated in hair follicles, and shortly thereafter discovered C. albicans (then Oidium albicans) the cause of thrush in children. His work was recognized in the New England Journal’s 200th Anniversary issue.
In 1923 Christine Marie Berkhout named what we now call Candida albicans, for the white robe, toga candida, worn by Roman senators and senatorial candidates. Albicans also comes from Latin, albicare meaning “to whiten.” A number of Candida species have been discovered through the years.
Now in addition to C. Albicans and others, there is new fungus to worry about and it could be even more deadly. The organism, C. auris (the latin name for ear), is a species reported in Asia as a rare cause of ear infections in 2009; it had not been found among large repositories of samples collected prior to 2013. Retrospective review of Candida strain collections found that the earliest known strain of C. auris dates back to 1996 in South Korea.)
Its virulence is particularly life threatening because bacterial resistance to antibiotics now includes a worldwide emergence of similar development for drugs used to treat fungal diseases.
The inability to control these infections presents a grave risk for both human and animal health. Like C. albicans, C. auris preys on people with weakened immune systems, and it is quietly spreading across the globe.
According to the New York Times, over the past five years it was found in a neonatal unit in Venezuela, swept through a hospital in Spain, forced a prestigious British medical center to shut down its intensive care unit, and taken root in India, Pakistan and South Africa. Cases of C. auris have been identified in 33 countries across five continents.
Recently, C. auris reached New York, New Jersey and Illinois and at least nine other states, leading the federal Centers for Disease Control and Prevention (CDC) to deem it an emerging threat. The outbreaks in the New York area have involved four different varieties, suggesting that the strains were introduced from other countries seeking medical care. Once the organism is introduced into a facility, transmission of single C. auris strains is efficiently spread from patient to patient.
The CDC is concerned about C. auris for three main reasons: 1. It is often multi-drug resistant, 2. It is difficult to identify with standard laboratory methods, and can be misidentified in labs without specific technology, and 3. It has caused outbreaks in healthcare settings.
C. auris has caused bloodstream, ear and wound infections. It also has been isolated from respiratory and urine specimens, but it is unclear if it causes infections in the lung or bladder.
In the U.S., 725 confirmed and 30 probable cases of C. auris have been reported as of June 30, and 1,474 patients have been found to be colonized with the fungus as of July 12.
As mentioned above, C. auris often does not respond to commonly used antifungal drugs, making infections very difficult to treat. Patients who have been hospitalized in a healthcare 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 drugs, appear to be at highest risk of infection.
Final thoughts
The Centers for Disease Control and Prevention maintains a web page with general information about Candida Auris together with a Fact Sheet that can be downloaded.
Max Sherman is a medical writer and pharmacist retired from the medical device industry. He has taught college courses on regulatory and compliance issues at Ivy Tech, Grace College and Butler University. Sherman has an unquenchable thirst for knowledge on all levels. Eclectic Science, the title of his column, touches on famed doctors and scientists, human senses, aging, various diseases, and little-known facts about many species, including their contributions to scientific research. He can be reached by email at [email protected].
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