A case in Mestre, which however worries because the so-called killer fungus, Candida ear, is potentially lethal and drug resistant. The isolated case at the Angelo hospital in Mestre concerns a man who allegedly contracted the fungus abroad. And if it is true that we know how to prevent it, it is equally true that if it affects immunosuppressed people or people hospitalized, mortality can go from 30 to 50% and even more.
The mystery of Candida auris, the fungus that “can kill in 90 days”
by VALERIA PINI
What is Candida auris
Candida ear is a yeast related to the variant albicans which causes the common sexually transmitted candidiasis, capable of developing an opportunistic infection with higher resistance to antifungals. Already in June 2020 the Ministry of Health had alerted the microbiology laboratories with a circular to “implement the diagnostic capabilities and the appropriate prevention and control measures for Candida auris, to avoid the spread of this highly infectious, persistent and lethal pathogen”. And emerging.
Candida auris, questions and answers on the fungus which is already an epidemic abroad
by VALERIA PINI
In Italy about twenty cases
In our country, no more than twenty cases have been recorded so far, but Candida auris has the potential for a hospital epidemic. The professor explains Francesco De Rosa, director of the infectious diseases department of the City of Health of Turin. “Without making unnecessary alarms, we can define it as a fearful infection but in healthcare environments: this is because it manages to develop in immunosuppressed patients or those who follow long antibiotic or cortisone therapies, with serious manifestations of the disease often also due to the pathology for which one is in hospital “. And in this case, hand hygiene and cleaning with common disinfectants may not be enough: Candida ear it is covered with a biofilm which makes hydrogen peroxide as well as chlorhexidine less effective.
“The anti-Candida auris drug”
daniele banfi
The therapies
There are three classes of antifungals used to treat invasive infections: azoles, polyenes, and echinocandins. 90% of isolated cases are resistant to at least one of the three and more and more often they are found with more complex, incurable resistance profiles. Although resistance to azoles and polyenes is very common, 1% of infections are also resistant to echinocandins.
Beware of humidity
The super fungus lurks everywhere, especially in humid environments. It can colonize bathrooms, beds, surfaces and is transmitted from human to human by proximity and contact. This is because “unlike others, it also proliferates at room temperature. It was first isolated in humans in the auricle of a Japanese patient in 2009 and since then we have seen how it can easily colonize and create infections in the blood using ports of entry such as wounds, skin lesions, mucous membranes and venous accesses “.
How to identify it
A close collaboration with microbiology is the first weapon one has to identify it. In Italy we monitor hospital infections and this has also made it possible to realize the importance of the phenoman of drug resistance and the need for new molecules capable of dealing with this kind of infections. Obviously – as the ministerial circular also writes – identifying the sick immediately allows them to have a better prognosis but also to avoid or in any case identify outbreaks early.
Infections in the hospital
Infections related to in-hospital care affect some 284,000 people every year in Italy alone, 10% of hospitalizations in pre-Covid times. And the number of dead fluctuates between 4,500 and 7,000. According to Review on Antimicrobial Resistance, as of 2016, by 2050, bacterial infections will cause more deaths than cancer, which already causes 10 million deaths a year. This is if no new pathogens emerge.