Via CBC News: Doctors and scientists mystified by spread of Candida auris superbug. Excerpt:
The emergence of a partially drug-resistant fungal infection in Canadian hospitals and elsewhere has doctors and scientists scrambling to understand the pathogen and stop its spread.
Candida auris was virtually unknown until 2009, but the past decade has seen outbreaks of infection in hospitals and long-term care facilities around the world, predominantly among patients with weakened immune systems, such as people receiving chemotherapy or surgery and those who receive medication through large intravenous lines.
So far C. auris remains relatively rare, said Dr. Isaac Bogoch, an infectious disease physician at Toronto General Hospital. But the fungus, which can cause infections, including of the blood, of wounds and ears, has three main features that make it worrisome to health-care professionals:
• It's tricky for some laboratories to identify.
• It can be hard to treat successfully when it invades the bloodstream.
• It's frequently resistant to one or more classes of antifungal medications that doctors turn to first.
"It poses a bit of challenge to treat, and the reason is there can be delays in diagnosis: conventional labs might not be able to detect that it's Candida auris right away," said Bogoch.
"With the delayed diagnosis, that can often delay appropriate treatment — and if we delay treatment for fungal infection, especially when they're in the blood, people can get very sick, very quickly."
Serious infection
In Canada, provincial laboratories and the National Microbiology Laboratory in Winnipeg are able to identify the specific infection. In the developing world, detection isn't always possible, according to the U.S. Centers for Disease Control and Prevention.
Symptoms may not be noticeable because patients with C. auris infection are often already sick in the hospital.
Based on information from a limited number of patients, the CDC estimates more than one in three patients with invasive C. auris die.
Canada has had a total of 20 cases of C. auris from 2012 to June 2019, the Public Health Agency of Canada (PHAC) said:
• 6 cases in Central Canada (Quebec or Ontario) between 2012 and 2017.
• 14 cases in Western Canada (Manitoba, Saskatchewan, Alberta or British Columbia) between 2014 and June 2019.
Canada's first case of multidrug-resistant C. auris was diagnosed in July 2017, imported by a returning traveller, said PHAC spokesperson Anna Maddison.
Some — but not all — of the resistant infections were acquired in hospitals outside Canada, Maddison said. It's not known how the others acquired it.
"We absolutely will be seeing more cases," Bogoch said.
