Dangerous, parasitic fungus Candida auris is becoming more common in hospitals; here are details about it

Candida auris can be deadly. (Photo by Kateryna Kon,
Science Photo Library via Getty Images)

When you think of fungi, you may think of spring mushroom hunting, but there are many "funguses" among us. Many are "parasitic in humans and are known to cause diseases. . . . Parasitic fungi most commonly enter the body through a wound in the epidermis (skin). Such wounds may be insect punctures or accidentally inflicted scratches, cuts, or bruises," says the Encyclopedia Britannica.

That is precisely how a new fungus is infecting humans. "In late March 2023, the Centers for Disease Control and Prevention highlighted the threat posed by a rapidly spreading fungus called Candida auris that is causing infections and deaths among hospital patients nationwide. The unexpected rise of this recently discovered pathogen is part of a larger trend of increasing fungal infections in the U.S.," reports The Conversation, a platform for journalism by academics.

Arif R. Sarwari is a physician and professor of infectious diseases at West Virginia University. Amid rising concerns among doctors and public health officials, Sarwari helped explain what Candida auris is, how it is spreading and how worried people in the U.S. should be." This information is particularly important for rural residents who tend to be older, sicker and have fewer medical resources for education and prevention. Here's the interview:

What is Candida auris? A recently identified, single-cell fungus that can infect humans and is moderately resistant to existing antifungal drugs. You might be familiar with superficial fungal infections – like athlete's foot or vaginal yeast infections – which are quite common and don't pose significant risks to most people. In contrast, Candida auris and other related fungi can cause infections within a person's body and are much more dangerous. . . . Recently, though, infections with species of candida that are much more resistant to drugs than Candida albicans – like Candida auris – have shot up, with a nearly fivefold increase since 2019."

How dangerous are candida infections? For the most part, healthy people do not have to worry about invasive candida infections. Two groups of people are most at risk for candida infections: first are patients in intensive care units who also have central intravenous catheters and receive broad-spectrum antibiotics. Patients with weak immune systems, such as cancer patients on chemotherapy, are also at high risk of candida infection. . . . The fungi can proliferate rapidly and overcome a person's immune system when a patient is sick and on antibiotics. . . . If candida cells on a person's skin contaminate an intravenous line, the fungus can get into a patient's bloodstream and cause often deadly bloodstream infections.

What treatments are available? Three classes of antifungal drugs can be used to fight invasive candida infections. Candida albicans are susceptible to all three and easier to treat than Candida auris, which is moderately resistant to all three classes of antifungals.

How common are invasive fungal infections? The CDC estimates that in the U.S., around 25,000 patients get candida bloodstream infections every year. . . . The recent emergence of drug-resistant and more transmissible Candida auris is raising alarms among health professionals. Because this species can contaminate surfaces and easily spread from patient to patient, the fungus is causing outbreaks both within and between hospitals.

Why are fungal infections increasing? The reasons for this increase are complicated, but I think there are two main drivers: more sicker patients in hospitals and a stressed health system. . . . I view the rise of drug-resistant fungi like Candida auris through the same lens as worsening antibiotic resistance. The more antibiotics people use, the greater the chances a resistant strain will become dominant.

What can the medical community do about it? There are a few options for fighting the rise of drug-resistant Candida auris. The most effective measures are good infection control practices. These protocols include practicing good hand hygiene taking measures to detect Candida auris infections early, and isolate patients to prevent the spread. Though relatively simple, these actions are key to preventing the spread of all antibiotic-resistant pathogens, not just fungi.