While C. auris has long been known to be difficult to treat, researchers first identified five patients in Texas and Washington, DC, whose infections did not respond to any of the three main classes of antifungal drugs. Pan-resistance had previously been reported in three patients in New York who were being treated for C. auris, an official with the CDC, who specializes in fungal diseases.
“What is worrying is that those at risk are no longer the small group of people who have infections and are already being treated with these drugs,” she said.
Infectious disease specialists say the coronavirus pandemic likely accelerated the spread of the fungus. The lack of personal protective equipment, which hampered health care workers during the first few months of the pandemic, has increased the chances for the fungus to be transmitted, especially among the thousands of Covid-19 patients who received invasive mechanical ventilation.
The chaos of the past few months didn’t help either. “Infection control efforts in most healthcare systems are few and far between in the best of times, but with so many Covid patients, resources that may have been used for infection control have been diverted elsewhere,” said Dr. Clancy.
For many health professionals, the appearance of pan-resistant C. auris is a sobering reminder of the threats posed by antibiotic resistance, from super bacteria like MRSA to antibiotic-resistant Salmonella. 2.8 million Americans develop such infections annually, killing 35,000, according to the CDC
Dr. Michael S. Phillips, chief epidemiologist at NYU / Langone Health, said health systems across the country are struggling to contain the spread of such pathogens. The problem is particularly acute in large cities like New York, where critically ill patients commute between nursing homes with lax infection control and world-class medical centers that often attract patients from a wider region.
“We need to do a better job of surveillance and infection control, especially in places where we put patients in group settings,” he said. “Candida auris is something to be concerned about, but we mustn’t lose sight of the bigger picture as there are many other drug-resistant bugs to be concerned about.”