“Super fungus” Infection Cases in ICU of a Brazilian Hospital

Recently, a report published in the Journal of Fungi showed that the first cases of infection with the deadly super fungus Candida Auris (C. Auris) were found in the COVID-19 intensive care unit (ICU) of a Brazilian hospital.

 

C. Auris is a multi-drug resistant fungus that can cause invasive infections, which was first discovered in Japan in 2009. Since then, at least 12 countries including South Korea, Pakistan, India, South Africa, Kenya, Kuwait, Colombia, Venezuela, and the United Kingdom have reported cases of C. Auris infection. C.Auris is also known as “super fungus” because of its multi-drug resistance and high fatality rate.

According to the US Centers for Disease Control and Prevention (CDC), C. Auris is becoming a serious global health threat, which, at the end of 2019, was included as an urgent threat in CDC’s Antibiotic Resistance Threats Report.

At the end of 2020, Brazil reported this deadly super fungus for the first time. The report published recently shows that the ongoing COVID-19 epidemic has created a favorable breeding environment for the emergence and spread of this super fungus in hospital ICU.

C. Auris is believed to have been infecting humans since the 1990s. Although its exact origin is still a mystery, scientists claim that C.Auris has only recently begun to have a serious impact on humans. Its great threat to public health is its ability to rapidly develop resistance to antifungal drugs. Symptoms of mild infection include chills and fever. However, in severe cases, it can invade a person’s blood and organs, and may cause organ damage or even life-threatening sepsis. Although not all super fungal infections cause severe disease, their tenacious resistance makes serious infections difficult to treat, especially for patients who are already weak or weakened in immune function, which will eventually lead to death.

To make matters worse, it is difficult to use conventional disinfectants to kill the super fungus in the environment where it reproduces in vitro.

Since 2019, hospitals around the world have maintained a high degree of vigilance against this fungus. In December 2020, Brazil became the latest country to discover it.

The report shows that the first batch of cases are two hospitalized patients infected with SARS-CoV-2, a 59-year-old male and a 72-year-old female, who were admitted to the same ICU in El Salvador City Hospital in October last year. Among them, male patients received glucocorticoid treatment for up to 34 days due to symptoms of COVID-19 and severe kidney damage. During this period, C. Auris infection, multi-drug-resistant Gram-negative bacteria, and multiple infections of Enterococcus faecalis occurred. The patient received antifungal therapy for 17 days and was discharged 49 days later. The other female patient was not so lucky. Due to the combination of chronic renal insufficiency, diabetes, and high blood pressure, the SARS-CoV-2 infection not only brought her severe symptoms of COVID-19 (respiratory distress), but also caused sepsis. The patient was treated with broad-spectrum antibiotics in addition to glucocorticoid therapy and non-invasive ventilation support. Later, the doctor discovered that she was not only infected with carbapenem-resistant Acinetobacter baumannii, but also C. Auris. In the end, she defeated C. Auris, but died of a bacterial infection.

After the first batch of cases appeared, another 9 patients that have been receiving treatment in the ICU since December 2020 were recently diagnosed with C.Auris infection.