This multi-resistant fungus becomes an urgent threat to global health

His name is Candida auris. This yeast Microscopic is a growing concern in hospitals around the world. Because, like bacteria multidrug-resistant 700,000 people dead in the world, the mushroom C. auris seems to resist most antifungals known as fluconazole, amphotericin B or echinocandins. About 90% of strains would be insensitive to at least one antifungal and 30% to three or more.

An epidemic that affects the whole world

In the United States, the Center for Control and prevention disease (CDC) qualifies C. auris from « new emerging global threat ". Since the first case identified in 2009 in Japan, the disease spread to the whole planet: South Korea, India, China, Colombia and Venezuela, United States, Canada and Europe … In the United States, 587 cases have been identified since the arrival of pathogenic in 2013, including 309 in New York alone. In Europe, the European Center for Disease Prevention and Control (ECDC) also warns aboutworrying increase in the number of cases, with 620 infections recorded between 2013 and 2017 in six countries, the majority in Spain and the United Kingdom (two in France).

Most cases are patients at immune system weakened or having undergone an operation In a hospital. The fungus is introduced by a wound, the ears or the urinary tract and then colonizes the blood system. The symptoms (fever, aches, fatigue …) are benign in ordinary people but can be fatal in fragile individuals. According to the different studies, the mortality rate would rise from 30% to 57% once the fungus reaches the blood system.

This disturbing epidemic yet remains largely under radar. On the one hand, identification tests remain quite complex and not implemented. Some hospitals take more than a year to discover the presence of the fungus, which has meanwhile had the opportunity to infect other patients. Infected material and people remain contagious for several months even after drastic hygiene measures. But the epidemic is mainly the subject of a climate of secrecy: neither the Royal Brompton Hospital of London, which had to close a dozen days in 2016 for decontamination, nor the polyclinic La Fe de Valence in Spain, in which 140 people were infected in 2016 and 2017, did not think it useful to make a public communication: no need to scare patients, argue their officials. " Healthcare institutions fear losing their reputation Explains infectious disease specialist Silke Schelenz in the New York Times.

Mbadive use of fungicides in question

Candida auris is not the only case of mushroom resistant. In the 2000s, Aspergillus fumigatus had already proven resistant to itraconazole, an antifungal that was thought to be effective against all mushrooms. There is no point in pouring into psychosis : only a dozen mushrooms are potentially dangerous for humans out of five millioncash who populate the planet. But if these pathogens become insensitive to more and more treatments, one could well witness a drama as extensive as that of "superbugs". The researchers think that it is the same mechanism of resistance which is at work: as in the case of antibiotics, antifungals are widely spread: fields of potatoes, tomatoes, beans, corn, but also on the flower beds and in the gardens.

So what to do? The ECDC advocates in particular an improvement of the prevention, with a watch on the reports, the strict isolation of the infected patients or the general measures of hygiene. Better information between hospitals must also be put in place, including a report on the transfer of a patient carrier.