Deadly Superhongo scares the world that has already been killed in Colombia

The Candida auris & # 39; is a mushroom that makes fun of almost any medicine. When it attacks, it can quickly lead to death and, because of its strong and silent spread over the past five years, has become a serious disease. threat to global health, especially in hospital settings where it tends to settle.

According to the United States Center for Disease Control and Prevention (CDC), this super-resistant germ has wreaked havoc in Venezuela, Spain, England and caused panic in India, Pakistan and South Africa, among other places.

A few months ago, the "Candida auris" arrived in the United States and visited New York, New Jersey and the state of Illinois, forcing the health authorities of that country into the United States. include in the list of germs considered as "urgent threats". "

Last Sunday, the newspaper's The New York Times & # 39; has eloquently related the death of an elderly man at Mount Sinai Hospital in Brooklyn, at the hands of the dreaded fungus, with the aggravating circumstance that the virus had spread in all the corners of his room, to such an extent that it was necessary to "detach some of the ceiling and floor tiles to eradicate them".

Scott Lorin, director of the hospital, said it was on walls, bed, doors, curtains, phone, sink, mattress and in all containers: a level of contamination observed in some microorganisms.

Hospitals are particularly vulnerable to this fungus, not only because of their ability to stay long on the surfaces and their incredible resistance to drugs, but also because, according to Jorge Cortes, infectiologist and professor at the National University, he is more easily affected. people with weak defenses, including badfeeding children, the elderly, smokers or cancer patients, among others.

What makes Candida 'auris' particularly alarming is its tenacity, says Carlos Álvarez, former president of the Colombian Association of Infectious Diseases, because Although it is not transmitted from person to person, this fungus persists in the skin and on the inanimate elements, in which it is fixed for a long time, thus preserving the ability to affect those who, because of its conditions, can turn it into a deadly weapon..

In fact, according to the CDC, nearly half of infected patients die before 90 days and, although the Brooklyn patient was a prominent media reference, until March 29, 587 cases had already been confirmed in the United States. UU

Hard to kill

And who is this enemy? Candida auris is a yeast-like fungus, according to the National Institute of Health (INS), adding that it is multidrug-resistant, that is, it is not not easily removed, nor with the antifungals (antifungal substances) They use clbadically. According to the INS, this limits the therapeutic options and therefore its danger.

His history of injury dates back to 2009, when he was found in the ear of a 70 – year – old woman who was hospitalized in Tokyo and who could not eradicate the infection despite the symptoms. multiple treatments. On this basis, microbiologists Kazuo Satoh and Koichi Makimura called it "auris" to link it to the atrial space from which they managed to isolate it.

Carlos Álvarez says that it is a mushroom that, from the point of view of the fight against infections, behaves like a bacterium and that the problem in health facilities is that it is a problem. it is also resistant to disinfectants commonly used for cleaning in hospitals. .

How does he act? Álvarez says that This fungus invades people's blood and configures what is called fungemia, through which it can be sown in the brain, kidneys, liver, bones, muscles, joints, vessel and even the eyes , creating a systemic infection called candidiasis.

This condition, by its very nature, weakens the entire organism to the point of collapsing rapidly, a situation that is aggravated by the fact that most of those affected suffer from other serious illnesses, which increases the risk of death.

Who does this affect? As we have already said, people with very weak defenses, but there are also other risk factors, such as recent surgeries, the presence of diabetes or people who have used antibiotics or broad spectrum antifungals. According to Alvarez, you should also suspect their presence in people who have spent a lot of time in hospitals, mainly geriatric, and some elements are connected to their veins, tubes or tubes to breathe. But the infectologist says that he can attack people of all ages.

How is it transmitted? This fungus lives mainly in hospital environments (but not exclusively), settles on surfaces and equipment, and humans can carry it in their skin. And the key point is when he manages to get into the blood, by all means.

Why is it so dangerous? The danger lies mainly in the fact that it is a micro-organism against which, according to Álvarez, the antifungals (clbadical specific antibiotics) do not work, because they have developed a resistance to them, also because 'they are often confused with other species of' Candida '.

Why is it so resistant? The fungus appears to have an innate resistance, fruit of an evolutionary divergence of at least 4000 years, which has increased with the widespread use of antifungals in medicine and even in agriculture. "This yeast has a great ability to survive the medications it faces, and it even seems to have a lengthy lead over the protection of those who develop," said Álvarez.

At least 17 cases here

According to a study published in January 2017 in "Emerging Infectious Diseases", entitled "Invasive infections by resistant yeast, Candida auris", Colombia claims to have found 17 cases of fungal infection, of which 35.2% died before 30 days.

The badysis conducted by José Rodríguez, Carlos Álvarez and Soraya Morales-López indicates that patients were hospitalized in six facilities in northern Colombia between February and July 2016, including nine men, aged between 77 and 88 years old. 2% of them were hospitalized in intensive care units.

Almost all the fungus has been detected in the blood, but in some cases in the peritoneal fluid, cerebrospinal fluid, bones and urine. Most had catheters and probes.

In terms of treatment, 15 of them received broad-spectrum antimicrobial treatments and fungal drugs administered at different times.

Researchers have reported an identification problem because it is mistaken for another fungus in the family of "candida". Since then, tests have been standardized to identify it more precisely.

What to do? The presence of this germ in the country has led the National Institute of Health to define specific parameters for notification and monitoring. Similarly, he proposed measures to prevent its spread, among which are distinguished: the rigorous washing of hands, the wearing of gloves when handling blood or body fluids, the protection of the face, wearing glbades, Protective clothing, avoid direct contact with splashes of contaminated items, as well as cleaning, disinfection and sterilization of all items that have been in contact with suspicious persons.Any patient with or suspected of having the fungus should be isolated, treated with protective clothing, and avoid contact with other components of the fungus.

Irrational use of antibiotics

The emergence of these super-resistant germs is mainly due to the blind use of antibiotics, as many of them have become smarter than these drugs.

The problem, explains Carlos Alvarez, is that, faced with a badly used antibiotic, the surviving germs modify (mutate) their genetic material, which immunizes them. hospitalization, livestock pens or sewerage systems share these characteristics of genetic resistance, with which they transmit to other microorganisms this condition of immunity.

In this sense, the recommendation is fundamental: do not use antibiotics without medical preparations and, when they are prescribed, you must take them strictly, according to the indication.. "Antibiotic resistance is a global threat against which no one is immune," Álvarez said.

CARLOS FRANCISCO FERNÁNDEZ R.
El Tiempo Medical Advisor