What are the risks of the deadly superfungus that causes an outbreak in Pernambuco – 05/29/2023 – Health

The Health Department of Pernambuco confirmed, at the end of May, three cases of infection by candida aurispopularly known as “superfungus”.

According to the information released so far, the patients are male and were admitted to three different hospitals in the cities of Paulista, Olinda and Recife.

The first diagnosis took place on May 11 at Hospital Miguel Arraes, in Paulista. For now, the health unit has stopped making new appointments to prevent other people from being affected by this pathogen.

O candida auris was detected in the other two individuals on May 14 and 23, respectively.

Experts have not yet been able to establish a chain of transmission and whether there is any relationship between the three episodes that occurred in different locations.

The Government of Pernambuco announced on Friday (26/5) the creation of a specific committee to monitor and deal with cases of infection.

This is not the first time that the State has suffered from an outbreak of this type: between December 2021 and September 2022, the Hospital da Restauração, in Recife, registered 47 individuals affected by this “superfungus”.

But why candida auris cause so much concern? And what are the individual and collective risks of this fungus?

Contamination difficult to control

In most cases, yeasts of the genus candidate they reside on the skin, mouth and genitals without causing problems, but they can cause infections when a person has low immunity or when this fungus invades the bloodstream or lungs.

In the specific case of candida aurisit often causes problems with the bloodstream, but it can also affect the respiratory system, central nervous system and internal organs, as well as the skin.

The most common symptoms of this fungal infection are fever, chills, excessive sweating and low blood pressure – but there are many individuals who don’t have many symptoms to suggest.

The pathogen was first studied in 2009 in a patient’s ear canal in Japan – but recent research detected strains of it in 1996 in South Korea.

The average mortality rate of this disease is estimated at 39%, according to calculations in a study by seven Chinese researchers published in the scientific journal BMC Infectious Diseases in November 2020.

According to infectologist Arnaldo Lopes Colombo, a professor at the Federal University of São Paulo (Unifesp) and a specialist in fungal contamination, it is possible to be temporarily colonized by C. auris on the skin or mucous membrane without having problems. The fungus presents a real risk if it contaminates the bloodstream.

For the person to be infected, he explained to BBC News Brasil in 2019, he must have undergone invasive procedures (such as surgeries and use of a central venous catheter) or have a compromised immune system.

Patients hospitalized in intensive care units (ICU) for long periods and with previous use of antibiotics or antifungals are also considered a risk group for contamination.

In addition, the candida auris it is often confused with other infections, leading to inadequate treatment.

To complete, common detergents and disinfectants are not enough to eliminate the fungus from the environment. Often, health professionals need to close entire hospital wards and apply special products to make that place safe again to receive patients.

From a preventive point of view, basic care with hand hygiene, use of protective equipment in environments such as the ICU, and constant surveillance can help.

drug resistance

Since 2022, the candida auris is part of the World Health Organization (WHO) list of priority pathogens that pose a risk to health.

In the United States, the infection is spreading rapidly and at an “alarming” rate, according to the US Centers for Disease Control and Prevention (CDC).

Cases in the US almost doubled in 2021: they went from 756 to 1,471, according to an entity report released in March of this year.

In most infections diagnosed in American lands, the fungus was resistant to available treatments.

For this reason, the CDC classifies the situation as an “urgent threat related to antimicrobial resistance.” Many affected patients are in hospitals and nursing homes.

Another cause for concern is the increase in cases that have become “resistant to echinocandins”, which is the most recommended class of antifungals for the treatment of Echinocandin infection. Candida auris.

The CDC attributes the increase to the lack of preventive measures at health facilities and to improvements in case follow-up and diagnosis services.

Another factor that seems to have contributed, according to the entity, was the stress on the health system related to the covid-19 pandemic.

In Brazil, at least four major outbreaks related to this microorganism have been identified in recent years.

The episode that took place in Recife between 2021 and 2022 was the subject of a study published this year by scientists from the Oswaldo Cruz Foundation (FioCruz).

According to the researchers, the candida auris “requires great vigilance because of its high capacity to form colonies and biofilms, which contributes to the spread of the fungus”.

“Rapid and accurate identification of this species is essential to manage, control and prevent infections”, conclude the experts.

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