As the globe continues its march to stop antibiotic-resistant bacterial infections, there’s another, and very different kind of bug on the block: Candida auris. The Centers for Disease Control and Prevention (CDC) has placed Candida auris on its list of germs now considered an “urgent threat” in the U.S. with 587 cases of people having contracted the “super fungal” to date. The highest concentrations of C. auris are in New York, New Jersey and Illinois, according to the agency.
The fungi resist major antifungal drugs and are considered remarkably stubborn and virulent because of how quickly they spread and cling to virtually everything within a surrounding area where a patient is infected – bedrails, curtains, telephones, sinks, walls – where it continues to live and thrive. The CDC says 30 percent of patients who contract the fungal infection die. But not until recently has C. auris - because of a lack of solutions to stop it - become something that healthcare leaders are willing to talk about publicly.
“This hushed panic is playing out in hospitals around the world,” reported the New York Times. “Individual institutions and national, state and local governments have been reluctant to publicize outbreaks of resistant infections, arguing there is no point in scaring patients — or prospective ones.”
This growing army of fungi is basically shrugging off modern medicine much the same way antibiotic resistant bacteria does, adding more problems to an already serious and major challenge.
Authors of a study published in Clinical Infectious Diseases, said “Antimicrobial effectiveness is a precious, limited resource. Therefore, preserving antibiotic effectiveness can be viewed similar to society’s responses to overconsumption and depletion of other precious, limited resources, such as oil and other energy sources, clean water and air, and forests.”
That was more than 10 years ago.
When the White House released its National Action Plan for Combatting Antibiotic-resistant Bacteria in 2016 it called for a 50 percent reduction in inappropriate outpatient antibiotic use in hospitals by 2020. In June that year the Centers for Medicare and Medicaid proposed rules that would require hospital-wide infection prevention and control and antibiotic stewardship programs solidly in place. Also, in 2016, the United Nations General Assembly — for the first time ever — placed antimicrobial resistance on its agenda, urging immediate and collaborative action across the globe.
According to the most recent Health and Human Services Progress report (year three), preliminary 2017 data show that 76 percent of all U.S. hospitals report having antibiotic stewardship programs that meet all of CDC’s Core Elements, compared to 64 percent in 2016. The goal is to have programs meeting CDC Core Elements of Hospital Antibiotic Stewardship Programs in 100 percent of hospitals by 2020.
Now, CDC is working to incorporate antifungal stewardship into existing efforts. Approximately 30 percent of patients with C. auris infections have died within 30 day, states the report. “C. auris has already become a major problem globally and, by February 2018, had gained a foothold in the U.S. with 233 confirmed clinical cases in 10 states.”
Despite what we know about antibiotic resistance, and the global call to curb unnecessary prescribing of antimicrobial medications, the problem continues in healthcare settings and agriculture. As noted in the New York Times, if this activity keeps up much longer, healthy people will be at risk, too, citing a study in the U.K. that shows death by antibiotic resistant infections could reach 10 million, surpassing projected cancer deaths by two million in 2050.
