A Mysterious Infection, Spanning the Globe in a Climate of Secrecy - The New York Times

The Creature from the Black Lagoon-- Candida Auris

If you are as old as I am you may remember this walking fungus from an early horror film. Now we have a new fungus threatening many hospitals.  Candida auris is becoming prevalent and is highly resistant to most antifungal drugs.  The increasing use of fungicides for crop management has caused the development of drug-resistant strains.

Last May, an elderly man was admitted to the Brooklyn branch of Mount Sinai Hospital for abdominal surgery. A blood test revealed that he was infected with a newly discovered germ as deadly as it was mysterious. Doctors swiftly isolated him in the intensive care unit. The man at Mount Sinai died after 90 days in the hospital, but C. auris did not. Tests showed it was everywhere in his room, so invasive that the hospital needed special cleaning equipment and had to rip out some of the ceiling and floor tiles to eradicate it.  “Everything was positive — the walls, the bed, the doors, the curtains, the phones, the sink, the whiteboard, the poles, the pump,” said Dr. Scott Lorin, the hospital’s president. “The mattress, the bed rails, the canister holes, the window shades, the ceiling, everything in the room was positive.”

The germ, a fungus called Candida auris, preys on people with weakened immune systems, and it is quietly spreading across the globe. Over the last five years, it has hit a neonatal unit in Venezuela, swept through a hospital in Spain, forced a prestigious British medical center to shut down its intensive care unit, and taken root in India, Pakistan and South Africa.  Nearly half of patients who contract C. auris die within 90 days, according to the C.D.C. Yet the world’s experts have not nailed down where it came from in the first place.

Recently C. auris reached New York, New Jersey, and Illinois, leading the federal Centers for Disease Control and Prevention to add it to a list of germs deemed “urgent threats.”

How does this occur? Microbes divide quickly and each division allows a possible mutation. Some of these mutations allow the microbe to metabolize an antibiotic to which the strain has been exposed.

Antibiotics are not foolproof and that is why so many new ones are brought to market, to replace those that are no longer effective.  It is not an inexpensive process. Each one must be approved by the Food and Drug Administration, an expensive process, along with clinical trials, a time consuming multi-step process requiring multiple stages of an investigation.

Yet as the problem grows, it is little understood by the public — in part because the very existence of resistant infections is often cloaked in secrecy.

With bacteria and fungi alike, hospitals and local governments are reluctant to disclose outbreaks for fear of being seen as infection hubs. Even the C.D.C., under its agreement with states, is not allowed to make public the location or name of hospitals involved in outbreaks. State governments have in many cases declined to publicly share information beyond acknowledging that they have had cases.

“It is a creature from the black lagoon,” said Dr. Tom Chiller, who heads the fungal branch at the C.D.C., which is spearheading a global detective effort to find treatments and stop the spread. “It bubbled up and now it is everywhere.”

The blatant lack of transparency should cause an outcry from the public and must be investigated.


A Mysterious Infection, Spanning the Globe in a Climate of Secrecy - The New York Times: The rise of Candida auris embodies a serious and growing public health threat: drug-resistant germs.