Researchers from the Oswaldo Cruz Foundation (Fiocruz) compiled and described the 3rd outbreak of Candida auris in Brazil, the biggest one so far. The fungus infection occurred 9 times in a hospital in Recife, Pernambuco, between November 2021 and February 2022. As the microorganism manages to resist most antifungal drugs, it is a considerable threat to public health in the country.
- What is the difference between fungi and bacteria?
- Fungus from The Last of Us is real, but could it cause a pandemic?
C. auris first appeared in humans in Japan in 2009, along with a case of otomycosis, spreading to all continents. Originally inhabiting only swamps, the fungus was pressured by the global increase in temperature, and through natural selection, migrated to birds and then to Homo sapiens, arriving in Brazil in 2020, in a 59-year-old patient, in Salvador.
Symptoms, treatment and care
Some strains are resistant to candida infection drugs such as fluconazole, aphotericin B, and echinocandins. Although some cases are asymptomatic, others can cause fever, aches and chills, and even lead to death. Tolerating unusual temperatures for fungi — from 37 °C to 42 °C —, C. auris can withstand adverse environmental conditions for a long time, being able to infect patients in hospitals through contaminated equipment and hands of health professionals.
The 9 recently infected Brazilians included 7 men and 2 women, aged 22 to 70. The first case emerged in November 2021, and the last 5 were clustered in February last year. The focus of the study was on identifying cases whose timely diagnosis was quick and essential for treatment. This ensured a low number of deaths, demonstrating that the infection can be controlled, not spreading through the patient’s body.
Once in the body, C. auris can reach the bloodstream, generating invasive infections in other organs that can lead the patient to death, especially if he has comorbidities or is immunocompromised. One of the problems in diagnosis is that a host can carry colonies of the fungus with it, without infection or symptoms, for a long time, propagating it and generating outbreaks without realizing it.
In Brazil, we have documentation guiding health services about the prevention and treatment of C. auris infection since 2017, spread across laboratories, clinics and hospitals. Essential for the fight is the Laboratory of Taxonomy, Biochemistry and Bioprospection of Fungi at Instituto Oswaldo Cruz (IOC/Fiocruz), responsible for research and also for diagnosing infections by other types of fungus.
Source: Frontiers in Cellular and Infection Microbiology