For the first time ever, superbug fungal infections that are totally resistant to all major classes of antifungal drugs have been found spreading amongst hospitalized patients in Texas and Washington DC.
A report released by the US Centers for Disease Control and Prevention (CDC) details over 101 cases of Candida auris at hospitals and long-term care facilities in DC from January to April 2021, as well as 22 cases in Texas during the same period. Of all 123 cases, at least five were found to be resistant to all three major classes of antifungal medication.
Within 30 days, 30 percent of these 123 patients had died, although the report adds the "contribution of C. auris was unclear."
C. auris is an emerging fungus that was first described by Japanese doctors in 2009, but research indicates that it managed to simultaneously spring up in Pakistan, India, South Africa, and Venezuela around this time. The dogged yeast causes bloodstream infections, wound infections, and ear infections. It’s known to prey on people with compromised immune systems, especially in hospitals. Just recently, doctors in Brazil found hospitalized patients with COVID-19 were becoming infected with the persistent fungi.
This species of yeast is considered a "serious global health threat" by the CDC because it’s often resistant to multiple antifungal drugs commonly used to treat Candida infections — hence why it’s often dubbed a “superbug” — but some strains are resistant to all three available classes of antifungals. This is known as pan-resistance.
Pan-resistant strains of C. auris have been identified before, including in the US, but this is believed to be the first time clusters of these hardy strains have been found transmitted within US hospitals. As far as this report found, there was no known link between the cases in DC and Texas. The report did not specify which hospitals were affected.
The CDC did not explain why these two clusters have simultaneously emerged this year either, but it’s notable that the COVID-19 pandemic has seen a rising tide of drug-resistant bacteria and fungi.
It’s too early to know exactly what’s behind this apparent rise, but there are a few ideas. Firstly, many hospitalized COVID-19 patients also caught secondary infections because of their weakened immune systems, leading to an increase in antibiotic (and antifungal) use and stronger selective pressure on pathogens to evolve resistance. Secondly, the pandemic has seen sudden strains on hygiene and changes to medical practices that may have encouraged the rise of superbugs. For instance, the pandemic has seen a huge surge of people requiring ventilators, where it’s known drug-resistant infections can cling, lurk, and spread.
Whatever the cause, this won't be the last we'll see of vicious drug-resistant fungi strains. The scale of the threat is uncertain, but many experts and health authorities are expecting C. auris to become a major challenge to public health in the coming years and decades.