Anvisa (National Health Surveillance Agency) confirmed today the third outbreak of Candida auris in a public hospital in Recife. The species was detected in the urine of one patient.
Known as a “superfungus,” it is drug-resistant and, according to the agency, is considered a serious threat to public health. C. auris infection can be fatal, especially for immunocompromised patients or those with comorbidities. The first two cases were confirmed in Salvador in 2020.
The agency also warned that there is another suspected case under laboratory investigation, in a patient from the same hospital.
According to Anvisa, since the suspect was identified, a national task force, composed of several bodies, was activated to monitor and control the outbreak. The institution asked the microbiology laboratories to intensify surveillance and, in the face of a suspected or confirmed case, notify the health service and activate one of the Lacens (Central Public Health Laboratory).
Covid-19 may have created conditions for ‘superfungus’
A study published last year suggests that the hospital chaos created by the Covid-19 pandemic may have created the ideal conditions for Candida auris to proliferate.
Arnaldo Colombo, coordinator of the Special Laboratory of Mycology at the Federal University of São Paulo (Unifesp) and leader of the research, explains that fungi of the genus Candida (with the exception of C. auris)
are part of the human intestinal microbiota and usually only cause problems when there is an imbalance in the body. The most common is the appearance of superficial infections in the mucosa of the vagina (candidiasis) or mouth (thrush), usually associated with the species C. albicans.
In some cases, however, the fungus invades the bloodstream and triggers a systemic infection – known as candidemia – similar to bacterial sepsis. The invasion of the bloodstream and the exaggerated response of the immune system to the pathogen can cause damage to various organs and even lead to death. Scientific evidence indicates that when candidemia occurs in patients infected with C. auris, up to 60% do not survive.
“This species quickly becomes resistant to multiple drugs, being little sensitive to disinfectant products used in medical centers. In this way, it manages to persist in the hospital environment, where it colonizes health professionals and, later, critical patients who need prolonged hospitalization, such as of carriers of severe forms of covid-19”, says Colombo.
Several factors make patients infected with SARS-CoV-2 ideal targets for C. auris, including prolonged hospitalization, use of urinary catheters and catheters for central venous access (a gateway to the bloodstream), corticosteroids ( which suppress the immune response) and antibiotics (which unbalance the intestinal microbiota).
*With FAPESP Agency information