AUGUST 2023

DOCTOR IS IN
Fungal Infection
Making the Rounds
If you follow the news,
you may have heard
about drug-resistant
infections caused by an organism
called ‘Candida auris.’
This kind of news can
create concern; the goal of
this article is to help readers
understand the infection—who
is at risk, how it
spreads, associated symptoms,
and treatment.
C. auris, a fungus first
identified in 2009 in Japan,
has become a cause of severe infections
across more than 30 countries
worldwide. C. auris began spreading
in the United States in 2015, and
cases increased significantly in 2018.
At that time, the Centers for Disease
Control and Prevention (CDC) decided
it should become a notifiable disease.
Despite headlines, the infection
is still rare and healthy people do not
usually get C. auris infections. Affected
patients usually have serious underlying
medical conditions or weakened
immune systems, such as blood cancer
or diabetes.
Some people can carry the fungus
somewhere on their body even if it’s
not making them noticeably sick with
symptoms, a process called colonization.
When people have it on their bodies,
it can spread to nearby objects or
equipment, and in turn, spread to others.
Because of this, health care workers
are trained to properly identify a C.
auris infection.
DR. RENEE
JIDDOU
SPECIAL TO
THE CHALDEAN
NEWS
Many hospitals also
screen patients who are considered
high-risk or come
from long-term care facilities
to determine if they are
carriers. The most common
symptoms of an invasive C.
auris infection are fever and
chills that don’t improve after
antibiotics for a presumed
bacterial infection. Sometimes
specialized laboratory
technology is needed to help
diagnose the infection.
When diagnosed, there are things
that can be done to stop the spread.
For instance, C. auris can live on surfaces
for several weeks, so good hand
hygiene and properly disinfecting surfaces
is especially important. Health
care workers should wear
gowns, gloves and clean
their hands correctly before
and after patient care.
Patient rooms should also
be cleaned thoroughly with
a disinfectant that works
against this fungus.
Family members and
other close contacts of patients
with this infection
should clean their hands
with hand sanitizer or soap
and water before and after
touching a patient with C.
auris, or after touching any equipment
or other objects in the patient’s room.
There are many types of Candida,
with at least 30 causing infections in
humans. C. auris might be resistant to
medications commonly used to treat
other types of Candida infections,
meaning these medications will not
work to treat that specific infection.
Instead, many C. auris infections are
treatable with a class of antifungal infections
called echinocandins.
However, some C. auris infections
can be resistant to all three main classes
of antifungal medications, making
it difficult to treat. In such situations,
multiple antifungal medications are
used at high doses to try and treat the
infection.
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When people have severe infections,
such as it is in the bloodstream,
it can cause serious illness and even
death. In most C. auris cases that result
in death, the infected individual had
other serious, underlying illnesses.
Even after the infection is treated,
patients may continue to have C. auris
on their skin or other body sites that
does not cause infection but can still
spread to other patients. All these precautions
previously mentioned would
continue throughout their whole stay
in the hospital.
Although the risk of infection in
healthy people is low, patients and
family members should continue with
good hand hygiene, washing hands
thoroughly before and after touching
the patient or medical devices when
they return home. Handwashing is especially
important if a caregiver is caring
for multiple patients at home.
Routine testing for C. auris of family
members or other close contacts is
usually not recommended. However,
if someone who has frequent contact
with a person with C. auris is admitted
to a health care facility, they might be
checked to see if they carry it and help
prevent it from spreading further. This
is usually done with a swab of the skin
near the armpits and groin. People who
have tested positive for C. auris in the
past should inform their health care
providers of this. For more information
on C. auris, you can visit CDC.gov.
Renee Jiddou-Yaldoo, MD is a
specialist in Infectious Diseases at
Corewell Health’s Beaumont Hospital
in Grosse Pointe.
46 CHALDEAN NEWS AUGUST 2023