Specialists at the Centers for Disease Control and Prevention are planning a major strategy session for later in the month to fight against a new species of deadly, drug-resistant yeast infection that is believed headed toward the United States.
The CDC announced in late June that the new infection - Candida auris - already is in
nine countries on the Pacific Rim, South Asia, England and Latin America, and that it is nearly twice as deadly as its parent disease.
Dr. Tom Chiller, chief of mycotic diseases at the Centers for Disease Control and Prevention (CDC), told AMI Newswire last Friday that the strategy session later this month will pull together researchers from across the country.
The common Candida yeast kills about 40 percent of the hospital patients that it infects. That number pales in comparison with the new Candida auris, according to
Prof. Luis Ostrosky-Zeichner, the University of Texas (U-T) Medical School vice chairman of infectious diseases. “We’re talking about a 60 percent to 80 percent mortality rate,” he said.
Researchers worry about several things about this new yeast. Although the basic Candida was first identified in 1909, it has recently developed a resistance to the only three classes of drugs normally used to treat yeast/fungal infections.
It has also developed the ability to survive outside of the human body on just about any surface in a hospital. Furthermore, it is hard to track and identify because preliminary research on its genetic sequencing indicates that there isn’t just one Candida auris, but a number of local variants that have all developed at roughly the same time.
“Clearly, you have to rule out one source for” this new bug, said Peter Pappas, professor of medicine in the division of infectious diseases at the University of Alabama Medical School. He said it’s not as if some traveler got on a plane and went from place to place spreading this type of infection.
Chiller said the CDC is asking hospitals to pay close attention to any serious fungal infections they encounter and to contact the agency if something looks unusual.
Said Ostrosky: “Often [when] you see a new species of some resistant species emerge, you immediately think of drugs” being used on a patient for another reason. He said that doesn’t seem to be the case here.
And Pappas said there was no indication that the new type of infection occurred because of a manufacturer’s defect in any medicine.
Dr. David Perlin, the executive director of the Rutgers Regional Biocontainment Laboratory at Rutgers Medical School, said “one immediate question is whether Candida auris is an emerging global pathogen and poses a broader threat to high risk patients or is a more regional and confined problem.”
So far, only one case of the new yeast has been recorded in the U.S. That was back in 1913. “Therefore, this new bug is not a problem now in the United States,” Pappas said, “But I recently went to India, where this Candida auris is the most prevalent form of yeast infection everywhere. Therefore, It’s just a matter of time before it becomes worldwide.”
One approach to combating the infection is surveillance. The CDC put out a general alert to hospitals at the end of July. It is already getting responses. The most important responses are sample or isolates of the suspected bug. The other attack on Candida auris is researching its molecular and genetic sequencing structure, which is what Perlin is doing at Rutgers.
“We are just receiving resistant isolates from India,” he said, “We will first evaluate known mechanisms of resistance before performing the whole genome sequencing, Another important issue is understanding factors that promote selection for multi drug resistant pathogens like Candida auris, but it will happen soon.”
However, Pappas pointed out that "that kind of research takes a matter of months."