Health chiefs to tell hospitals how to treat a deadly fungus amid fears it is spreading globally 

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Public health bosses will advise hospitals on how to cope with a deadly fungus that has become resistant to most drugs.

Candida auris was first identified in 2009 and has since struck hundreds in Britain and the US, among other countries.

Hospitals are now struggling to deal with the little-known fungus, prompting health officials in England and Wales to step in.

Public Health England has said it is looking to update its guidance on C. auris amid fears it is ‘spreading like wildfire’. 

The agency first published guidelines for dealing with the fungus in 2017, including telling doctors to isolate infected patients and ramp up hygiene measures.

Candida auris has been identified across the globe since 2009.  Now, public health bosses will advise hospitals on how to cope with the deadly fungus that has become resistant to treatment

Candida auris has been identified across the globe since 2009.  Now, public health bosses will advise hospitals on how to cope with the deadly fungus that has become resistant to treatment

Some 260 patients have been found to have C. auris in Britain in six years, The Times reports.

The fungus can enter the bloodstream and spread throughout the body, causing serious infections and death, in some cases.  

Concerns have been raised because the fungus thrives in hospital settings and does not respond to commonly used anti-fungal drugs.

If a person is healthy they are unlikely to be affected by the fungus, but it can pose a more serious threat to a patient with a weakened immune system. 

Candida auris (C. auris) was first described in 2009 after being found in the ear canal of a 70-year-old Japanese lady.

In 2011, it was reported as a cause of bloodstream infection in South Korea.

It has since been identified in countries including Canada, the US, Venezuela, Colombia, South Africa and India, as well as the UK, Spain, Norway, and Germany. 

In the US there have been 587 reported cases, mostly in New York, New Jersey and Illinois, leading C. auris to be put onto an ‘urgent threats’ list by the Centers for Disease Control and Prevention (CDC).

Based on current information, 30–60 per cent of people with C. auris infections have died, according to the CDC. 

But many of these people had other serious illnesses that also increased their risk of death. 

A large outbreak in Oxford University Hospitals NHS Trust’s Royal Brompton Hospital in west London involved 72 patients between April 2015 and November 2016 and caused the hospital to shut its intensive care unit for 11 days.   

As of July 2017, no-one has died directly from C. auris infection in the UK, according to PHE.

Although, one person did die following the Royal Brompton outbreak due to other reasons.

Dr Johanna Rhodes, an infectious disease expert at Imperial College London, said she and her team is regularly called by NHS hospitals for advice on how to deal with outbreaks. 

According to the New York Times, Dr Rhodes received a panicked call from Royal Brompton hospital saying they couldn’t get rid of the fungus.

WHAT IS C AURIS? 

Candida auris (C auris) is a harmful form of yeast, identified by the CDC as a ‘superbug’ fungus.

It tends to be diagnosed in patients after they’ve been in hospitals for several weeks. 

The fungus can infect wounds, ears and the bloodstream and take root in the urinary tract. 

The source of the infection for C auris isn’t the person who got sick but rather the hospital environment, including catheters, counters, and other surfaces.

It was first identified in Japan in 2009 and has since spread to more than a dozen countries worldwide.

Two of the three kinds of commonly used antifungal drugs have had little effect in treatment.

About 60 percent of those who’ve been infected with C auris have died.

She said she was told: ‘We have no idea where it’s coming from. We’ve never heard of it. It’s just spread like wildfire.’ 

The CDC has said that more than 90 per cent of C. auris infections were resistant to at least one drug and 30 per cent to two or more. 

Dr Johanna Rhodes told The Times that ‘different mechanisms were responsible for its drug resistance’.

The fungus is resilient because it was able to create biofilms – micro-organisms that can stick to surfaces and make the fungus hard to remove.

Dr Rhodes said: ‘It has evolved to be a very fit organism and it is surviving and thriving in hospital environments.

‘We have never seen anything like this before. Don’t panic — this is not going to be the global pandemic that everyone hears about that is going to wipe out humanity. 

‘But people should be aware of how scary fungal infections can be.’ 

Researchers investigated the spread of C. auris after the outbreak in Royal Brompton and found that equipment including thermometers used to monitor some patients was identified as a major source.

Dr Rhodes said patients being moved from one hospital section to another, for example to rehabilitation, caused spread.

Without symptoms, the fungus can go undetected by medics – but doctors are, according to Dr Rhodes, getting better at identifying it. 

However, The New York Times reported that there is a ‘climate of secrecy’ around the fungus, and that hospitals are reluctant to discuss the challenge of containing it. 

‘We came to realize that the secrecy surrounding C. auris was a big part of the story,’ they wrote.   

Dr Colin Brown, consultant medical microbiologist for PHE’s national infection service, said C. auris is an uncommon fungus in the UK and is a low risk to patients in healthcare settings.  

He said: ‘PHE is working closely with the NHS to provide expert support and advice on infection control measures to limit the spread of Candida auris. 

‘Most cases detected have not shown symptoms or developed an infection as a result of the fungus.

‘NHS hospitals that have experienced outbreaks of Candida auris have not found it to be the cause of death in any patients.’   

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