Overcrowded intensive care units, exhausted health workers and chaotic situations in overcrowded hospitals: These and similar problems have created ideal conditions for the occurrence of Candida auris in Brazil during the course of the pandemic. This is a fungus that people can become infected with. If it gets into the bloodstream, it causes a systemic infection. Urinary tract infections are common, but the fungal disease can also damage several organs and even lead to death. In infected patients, C. auris mortality can reach 60 percent.
Resistant “super mushroom”
Experts refer to the microorganism as a “super fungus” because it spreads at high speed and at the same time increasingly develops drug resistance. For example, patients with C. auris should only be accommodated in single rooms to prevent it from spreading – this is not possible in times of overcrowded hospitals.
The first two cases of the “super fungus” were confirmed in December 2020 in a hospital in Salvador in northeast Brazil and now in Journal of Fungi described. “Nine more C. auris- Patients have since been diagnosed in the same hospital, some colonized (with the fungus in their organism, but not harmful) and others infected, ”said study author Arnaldo Colombo. “There is cause for concern. We observe the evolutionary characteristics of C. auris- Isolates from patients in the hospital in Salvador and we have already found samples with reduced sensitivity to fluconazole and echinocandins. The latter belong to the main class of drugs for the treatment of invasive candidiasis. ”In many hospitals, too little attention is currently paid to the fungus, but it should be identified quickly in order to contain its spread.
Disinfectants don’t help
“The species quickly becomes resistant to multiple drugs and is not very sensitive to the disinfectants used by hospitals and clinics,” said Colombo. As a result, the fungus may persist in hospitals, where it colonizes health workers and eventually infects patients with severe COVID-19 and other critical long-term patients.
Covid-19 patients are ideal targets for the fungus. They have long hospital stays, urinary and central venous catheters that allow entry into the bloodstream, and they are given steroids and antibiotics in their treatment, which in turn affect the intestinal flora. The virus could damage the intestinal mucosa of severe Covid 19 patients and thus facilitate the penetration of pathogens into the bloodstream – the patient becomes more susceptible to the fungal disease.
Other countries have also reported the appearance of Candida auris during the pandemic. According to the study authors, therefore, increased control of hospital patients is necessary. In order not to promote resistance, the use of microbial drugs in intensive care units should not be premature. Since the beginning of the pandemic, according to Colombo, some antibiotics have been prescribed more frequently – mostly without real justification.