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A deadly fungus that surpasses major antifungal medications is slowly spreading in the United States, prompting infectious disease physicians in western Pennsylvania to prepare for their arrival.
The fungus, called Candida auris, has been confirmed in New York and New Jersey, but no cases have been reported in Pennsylvania, according to the state's Department of Health. In March, the Centers for Disease Control and Prevention reported 617 cases throughout the country.
"It's only a matter of time before we see these organisms spread," said Dr. Tom Walsh, Infectious Disease Specialist and Medical Quality Director at Allegheny General Hospital. from Pittsburgh. "We learn a lot from all the places where it exists."
Nate Wardle, spokesperson for the Ministry of Health, said that health facilities are required to report a confirmed case. It also shares all information with health facilities through regular reviews and its health alert network, among others.
The CDC considers the fungus a "serious global threat to health". In addition to confirmed cases in 12 states, more than 20 countries reported cases of Candida auris, according to data collected by the CDC.
"The mortality is very high," said Dr. Amesh Adalja, senior researcher at the Johns Hopkins Health Center and infectious disease doctor in Pittsburgh. "It's a microorganism very difficult to manage."
Adalja said the people most at risk seem to be patients already suffering from a chronic illness or compromised immune system, as well as patients already admitted to a health care facility.
The fungus can cause blood infections, wounds and ear infections, according to the CDC.
The fungus can be difficult to diagnose because conventional laboratory tests can lead to misidentification and inappropriate treatment, making it difficult to control the spread of Candida auris.
It is difficult to treat because it often resists most common antifungal medications and is typically found in health care settings, including hospitals and retirement homes, where it could spread quickly. Some strains can be treated with high doses of several drugs, but some are completely resistant, according to the CDC.
Difficult to prevent
Adalja said that an average person could not do much to avoid contracting the fungus outside of normal hygiene practices such as washing hands. There is often no symptom until it has progressed considerably.
"You can not have any symptoms when it's just colonization," he said. "It is difficult for the general public to take specific measures."
Dr. Graham Snyder, director of infection prevention at UPMC, said there were so many unknowns about Candida auris that it was difficult to know what to expect.
"What's fascinating about this bug – and there's a lot more to learn – is that we do not know where it's coming from," he said. "He appeared in several different places of the world at the same time."
Snyder said it was difficult to predict how he would continue to spread. Currently, it is usually found in health care settings, but may not always be the case.
He cites MRSA infections as an example of a drug resistant stink bug that started only in medical facilities but which, after a few years, began to appear elsewhere. Infections are now reported in places such as schools and athletes who play sports with a lot of physical contact.
"It's very early in the history of Candida auris," said Snyder. "It is difficult to advise a person by saying," You must do x, y, z to avoid contracting Candida auris. "
Nevertheless, hospitals are preparing for the day a fungus could be diagnosed.
Walsh said the Allegheny health network had begun to do further tests when a patient was HIV-positive for any type of Candida in order to ensure that he was not missing Candida auris. The UPMC performs similar tests.
Walsh said that early identification is essential because the sooner a patient is diagnosed, the sooner the hospital can isolate and treat it before it is transmitted to another patient. other patients.
"It's a lot more work (but) we want to make sure we're ahead," he said.
Emily Balser is a writer for Tribune-Review. You can contact Emily at 724-226-4680, [email protected] or via Twitter .
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