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The US Centers for Disease Control and Prevention (CDC) has just issued an alert against the microscopic fungus Candida auris, considered an “urgent threat of antimicrobial resistance” and whose cases have been on the rise for several years. A threat to be taken seriously?
Faced with an increase in cases of contamination in 2020 and 2021, in hospitals in particular, by the microscopic fungus Candida auris, the Centers for Disease Control and Prevention (CDC) are issuing an alert.
What is Candida auris?
Candida auris is a microscopic fungus, detected for the first time in 2009 in Japan, in the ear of a patient, hence its name, auris meaning ear in Latin. The symptoms they cause vary and can range from no clinical manifestation to serious infection that can cause death. “It is indeed a nosocomial infection, which presents a strong resistance to antifungals.“underlines Professor Eric Caumes, infectious disease specialist and consultant at the Hôtel-Dieu in Paris.
Why is the CDC issuing an alert?
Candida auris was first detected in the United States in 2016. Today, the CDC says it is concerned that it has “spread at an alarming rate in US healthcare facilities in 2020-2021“, with a progression that continued in 2022. The CDC reports the figures as of December 31, 2021:
- 3270 clinical cases for which the infection is present;
- 7,413 cases of screening, for which the fungus is detected but does not cause infection.
For Dr. Meghan Lyman, CDC epidemiologist and lead author of the paper, “the rapid increase and geographic spread of cases is concerning and underscores the need for continued surveillance, expanded laboratory capacity, faster diagnostic testing, and adherence to proven infection prevention and control“.
What about France and Europe?
In France, “less than 10 cases (identified between 2015 and 2019) have been described to date. These were mostly isolated cases.” reports Public Health France in September 2020.
In Europe, 327 cases were identified between 2019 and 2021 in five countries – including France, therefore – according to data from Eurosurveillance, the European journal dedicated to the surveillance, epidemiology, prevention and control of infectious diseases.
Why such a difference between countries?
In the United States, the number of cases of C. auris has increased for many reasons, including due to “poor general infection prevention and control (IPC) practices in healthcare settings” estimate the CDC. “The number of cases may also have increased due to increased efforts to detect cases.”.
In France, the fungus did not create an epidemic situation. “Following the reporting of the first cases, the Haut Conseil de Santé Publique produced specific recommendations in 2019” indicates Public Health France, like “those implemented to prevent the spread of bacteria highly resistant to antibiotics“. In addition, a “monitoring by the National Reference Center for Invasive Mycoses and Antifungals (CNRMA)” is enabled, which makes “unlikely (the fact) that cases of C. auris candidemia have remained unrecognized” estimates the French health authority.
Who is most at risk from this fungus?
“In general, C. auris is not a threat to healthy people” reassures the statement of the CDC. “People who are very ill, who wear invasive medical devices, or who stay frequently or for a long time in healthcare facilities are at increased risk of contracting C. auris.” note however the American authorities. The infection is “often resistant to several antifungal drugs, spreads easily in healthcare settings and can cause serious infections with high mortality rates” they conclude.