Fungus Among Us: Are You at Risk?

There’s a fungus out there that doesn’t want to be cured. Similar to how some bacterial infections have become resistant to antibiotics, certain strains of the fungus Candida fight anti-fungal medications, making it hard to treat and sometimes posing fatal risks to certain groups of people who become infected with it.

The Candida auris fungus has progressed over recent years to be the source of life-threatening illnesses, including wound and bloodstream infections, according to a study published in the February issue of Emerging Infectious Diseases. Unlike the fungi that cause mouth, throat and vaginal yeast infections, the C. auris fungus causes bloodstream and ear infections.

First detected as the cause of an ear infection in Japan, it was cited as the cause of fungal outbreaks last year in hospitals located in Asia and South America. In the U.S., cases have popped up in Illinois, New York, Maryland and New Jersey.

Each year in the U.S., Candida is responsible for about 46,000 bloodstream infections associated with healthcare settings, according to the Centers for Disease Control and Prevention (CDC). Known as candidemia, this invasive infection usually requires an additional 3 to 13 days of hospitalization.

The CDC has found 7 percent of the C. auris fungus found in bloodstream infections is resistant to fluconazole, the most commonly prescribed anti-fungal medication.

“Antifungal medications are used for severe infections, especially those that are blood born,” said Rozan Razzouk, M.D., a Baptist Health Medical Group physician with Baptist Health Primary Care. “Any device introduced to the blood can cause infection. In a hospital setting, patients who have catheters or long-term IVs should make sure they and their caregivers practice good hand hygiene. Minimizing the use of a catheter can also help reduce risk of a fungus entering the bloodstream and causing dangerous infection.”

Most of these bloodstream infections are thought to stem from some species of the fungus that lives on skin and enters a person’s bloodstream through an intravenous (IV) catheter inserted during surgery. People who come in contact with medical equipment contaminated with the fungus can also become infected. In addition to causing bloodstream infections, C. auriscan also affect the heart, brain, eyes, bones and other parts of the body.

Resistance to another antifungal medication, echinocandins, has increased two-fold in recent years, to 8 percent in 2014, compared to 4 percent in 2008, CDC studies found. It’s needed to fight a different strain of Candida fungus, Candida glabrata, which causes urinary and vaginal infections. These types of fungal infections most commonly affect the elderly, diabetics and people with HIV/AIDS and others with weakened immune systems.

“Limiting the use of antibacterial medications is important in preventing drug resistance,” Dr. Razzouk said. “Antibacterial medications can wipe out helpful bacteria in the gut and make the body more prone to fungus infection.”

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