What’s going on with the spread of this fungus?
The mushroom candida auriswhich primarily attacks hospitalized people, has spread “at an alarming rate in US healthcare settings in 2020-21,” according to a new report from the Centers for Disease Control and Prevention (CDC) released Monday.
The number of cases in the United States has increased from 476 in 2019 to 1,471 in 2021. “And it continues to progress. The numbers we have so far for 2022 [aux États-Unis] are much worse than those of 2021. This is certainly very concerning, ”said Simon Dufresne, microbiologist at Maisonneuve-Rosemont Hospital.
Does Canada observe the same phenomenon?
The number of cases detected in Canada is much lower. Since 2012, 43 cases of candida auris have been reported to the Public Health Agency of Canada, including 35 in the past five years. Among these cases, 19 come from Quebec and Ontario, including two patients who were infected with the fungus at the Pierre-Boucher hospital in Longueuil last September.
However, it is only a “matter of time” before we observe an increase in its presence in Canada, estimates Adnane Sellam, researcher at the Montreal Heart Institute and specialist in candida auris. “You have to expect [à observer une hausse] and you have to prepare for it,” added Mr. Dufresne.
Is this mushroom dangerous?
The mortality rate is approximately 30 to 60%, but this proportion must however be qualified. Indeed, one can be colonized by the fungus without developing a true infection, explains Mr. Sellam. This “super resistant” yeast can lodge on the skin without causing symptoms.
Some patients, often those with weaker health or weakened immune systems, will however develop the infection. In these cases, the yeast enters the bloodstream and spreads throughout the body, says Sellam. It then causes symptoms such as fever and chills.
Who is at risk of being infected?
Infection with this fungus mainly affects hospitalized or immunosuppressed patients. It is transmitted by direct contact or by surfaces, but not by aerosols. Patients who have been hospitalized in a healthcare facility for a long time, who have a central venous catheter, or who have previously received antibiotics or antifungal medications appear to be most at risk of infection with this yeast, details the CDC. .
Is the infection easy to treat?
Infection with this fungus is often resistant to several drugs commonly used to treat it. “We don’t have a lot of options. [de traitement]. This is a huge concern because a doctor or infectious disease specialist should always have options to treat these patients,” says Sellam.
In the United States, the number of cases resistant to echinocandin, the most recommended antifungal drug for the treatment of this infection, tripled in 2021. In Canada, one-third of cases were multidrug-resistant.
How do we limit its transmission?
We need to be prepared to screen patients for this organism, says Dufresne. “Since 2017, we have had protocols in Quebec as much to guide hospitals if we have a colonized or infected patient as practice guides for laboratories,” he explains. “Since there are few cases in Canada, it’s probably a little early to launch a very aggressive monitoring program, but we are on alert,” he adds.
Is there a link between the spread of this fungus and climate change?
Possibly. According to Canada’s National Collaborating Center for Infectious Diseases, there is reason to believe that rising temperatures due to climate change are contributing to the spread of the fungus. “As soon as there is an increase in stress, in this case heat, [le champignon] can mutate, predisposing it to be a human pathogen,” says Sellam.