U.S. healthcare facilities nationwide are experiencing a multi-drug resistant and potentially deadly fugus that has been spreading with increasing speed, according to the Centers for Disease Control and Prevention (CDC).
Cases of the fungus, called candida auris, tripled over just three years, and more than half of states have now reported it, according to researchers at the CDC who wrote in a paper published Monday by Annals of Internal Medicine.
The fungus is usually not harmful to healthy people but can be a deadly risk to unhealthy hospital and nursing home patients. It spreads easily and can infect wounds, ears and the bloodstream. Some strains are so-called superbugs that are resistant to all three classes of antibiotic drugs used to treat fungal infections.
The fungus was first reported in the U.S. in 2016. The study analyzed recent changes of candida auris in the U.S. from 2019 to 2021. The overall trend found by the study suggests its increasing cases of infection, death and drug resistance.
The CDC study reported 3,270 clinic cases through the end of 2021, with clinical cases rose from 476 in 2019 to 1,471 in 2021. Overall, the clinic cases increased by 44 percent in 2019 and 95 percent in 2021.
Cases of colonization screening – which means that people were found to carry the fugus to potentially infect others but not sick with it -- totaled at 7,413. The screening cases tripled from 2020 to 2021.
The CDC has deemed candida auris as an urgent antibiotic resistance threat because it is often resistant to multiple antifungal drugs, spreads easily in healthcare facilities, and can cause severe infections with high death rates, according to CDC's news release.
The study found that in 2021, candida auris cases resistant to echinocandins – a class of anti-fungal drugs -- was about three times of that in each of the previous two years.
The fugus was found primarily in New York and Chicago at first. However, it has been spreading and by the end of 2021, 17 states had identified their first candida auris case, the study said.
"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.
The study found that most candida auris transmission has occurred in healthcare facilities that provide long-term care to very sick patients. People who are very sick, have invasive medical devices, or have long or frequent stays in healthcare facilities are at increased risk. The most common symptoms of candida auris infection are fever and chills.
Based on information from a limited number of patients, 30–60 percent of people sick with candida auris infections have died, according to the CDC. However, many of these people had other serious illnesses that also increased their risk of death.
The paper explained that candida auris case counts have increased for many reasons, including poor general infection prevention and control practices in healthcare facilities, and strain on healthcare and public health systems during the COVID-19 pandemic.
Case counts may also have increased because of enhanced efforts to detect cases, including increased colonization screening, the study said.
The Wall Street Journal reported that some experts speculated that rising global temperatures might have encouraged candida auris to evolve with more tolerance to heat, making it more adept at infecting people. In addition, widespread use of disinfectants and antifungals on crops might have contributed to candida auris's thrive by killing off microbial competitors.