The mysterious infection that is spreading around the world in a climate of secrecy

In May, an elderly man was admitted to the Brooklyn Branch of Mount Sinai Hospital for abdominal surgery. A blood test revealed that he was infected with an uncovered germ that was both deadly and mysterious. The doctors quickly isolated him in the intensive care unit.

The germ, a fungus called Candida Auris, feeds on people whose immune systems are weakened and it spreads silently throughout the world. For the past five years, he has been to a neonatal unit in Venezuela, has been hospitalized in Spain, has forced a prestigious British medical center to close his intensive care unit and has established himself in India, Pakistan and in South Africa.

Recently, Candida Auris has arrived in New York, New Jersey and Illinoisand the Federal Centers for Disease Control and Prevention add it to the list of germs considered as "urgent threats".

The man from Mount Sinai died after 90 days of hospitalization, but Candida Auris did not do it. Tests have shown that this virus was everywhere in your roomso overwhelming that the hospital needed special cleaning equipment and had to rip some of the ceilings and tiles to eradicate it.

"Everything was positive: the walls, the bed, the doors, the curtains, the phones, the sink, the slate, the poles, the pump," said Dr. Scott Lorin, president of the 39; hospital. "The mattress, the bed rails, the holes in the containers, the blinds, the ceiling, everything in the room was positive."

C. Auris is so tough, in part, because it is impervious to major antifungal drugsThis is yet another example of one of the most difficult health threats in the world: an increase in drug-resistant infections.

For decades, public health experts have warned that overuse of antibiotics reduces the effectiveness of life-prolonging drugs by curing bacterial infections that have already resulted in death. But recently, there has also been an explosion of resistant fungi, adding a terrifying new dimension to a phenomenon that undermines a pillar of modern medicine..

"It's a huge problem"said Matthew Fisher, Professor of Fungi Epidemiology at Imperial College London, who co-authored a recent scientific study on the increase of resistant fungi." We depend on being able to treat these patients. with antifungal agents. "

In short, fungi, like bacteria, develop defenses to survive modern medicines.

However, even when world health leaders have called for greater restraint in the prescription of antimicrobial drugs to fight against bacteria and fungi, a call has been made for: the United Nations General Assembly in 2016 to manage an emerging crisis: its excessive use in hospitals, clinics and agriculture continued.

The resistant germs are often called "superbugs", but this is simplistic because they do not usually kill everyone. Instead, they are more deadly for people with immature immune systems or compromised immune systems, including newborns and the elderly, smokers, diabetics, and people with autoimmune disorders. . who take steroids and suppress the body's defenses.

Scientists say that if new, more effective drugs are not developed and that the unnecessary use of antimicrobials is drastically reduced, the risk will extend to healthier populations.. A UK government-funded study indicates that, if no policy to limit the increase in drug resistance was implemented, 10 million people worldwide could die from all these infections in 2050, eclipsing the eight million who should die of cancer this year.

In the United States, two million people become infected each year and 23,000 die, according to C.D.C. estimate. This number was based on 2010 figures; More recent estimates from researchers at the University of Washington School of Medicine have estimated the death toll at 162,000. Deaths from resistant infections worldwide are estimated at 700,000.

Antibiotics and antifungals are essential to fight against human infections, but they are also widely used to prevent disease in farm animals and antifungals are also used to prevent rotting of agricultural plants. Some scientists cite evidence that the widespread use of fungicides in crops contributes to the increase of drug-resistant fungi that infect humans.

However, as the problem grows larger, the public misunderstands it, in part because the very existence of resistant infections is often hidden in secrecy.

With bacteria and fungi, hospitals and local governments are reluctant to disclose epidemics for fear of being considered as centers of infection.. Even the C.D.C., by virtue of its agreement with the states, is not allowed to make public the place or the name of the hospitals involved in epidemics. In many cases, state governments have refused to share information publicly, beyond acknowledging that they have had cases.

At the same time, germs spread easily: they are carried by hands and equipment in hospitals; transported in meat and vegetables fertilized with farm manure; transported across borders by travelers and in exports and imports; and transferred by patients from the retirement home to the hospital and back.

C. Auris, who infected humans at Mount Sinai, is one of dozens of dangerous bacteria and fungi that have developed resistance.. However, like most of them, it is a threat virtually unknown to the public.

Of other important strains of Candida fungus, one of the most common causes of blood infections in hospitals, have not developed significant drug resistance, but more than 90% of C. Auris infections are resistant to at least one drug and 30% to two or more drugs.

Dr. Lynn Sosa, badociate epidemiologist in the state of Connecticut, said she now considered C. Auris as the "main" threat among resistant infections. "It's pretty unbeatable and hard to identify"he said.

Nearly half of patients who contract C. Auris die within 90 days, according to C.D.C. However, experts around the world have not yet determined where it came from.

"It's a black lagoon creature," said Dr. Tom Chiller, head of the mushroom branch at C.D.C., who leads a global detection effort aimed at finding treatments and stopping the spread. "He was boiling and now he is everywhere."