In focus: Multi-drug resistant fungus, Candida auris
- Candida auris is a fungus discovered in 2009 that has developed resistance to commonly used anti-fungal drugs.
- ‘Candida auris’ is spreading across the globe adding a new dimension to anti-microbial drug resistance.
- WHO recognizes anti-microbial multidrug-resistance as one of the top 10 global public health threats in 2019.
- Thus, in addition to anti-biotic resistance, anti-fungal resistance is also emerging as a major global health threat.
Harmful effects of Candida auris
- The harmful effects of Candida auris is 2 fold
- Direct Infections
- It commonly causes infections in wounds, bloodstreams, and ears.
- In case of patients with weak immune systems it can cause invasive infections in blood, heart, brain, urinary tract and respiratory tract in which cases I can cause deaths in 1 in 3 patients.
- Spread of antifungal resistance
- While it is not life-threatening for healthy population, its spread is a serious public health concern due to multiple drug resistance it can develop.
- Thus rendering various anti-fungal drugs ineffective.
- People with weak immune system like old aged, neo-natal groups, patients of diabetes mellitus.
- Doctors and other Health care workers etc
Possible reasons for the spread
- Anti-fungals are usually used to prevent agricultural plants from rotting.
- Rampant use of anti-fungicides on crops could exacerbate the spread and infect healthy population.
- Since they are easily spread in the environment it can travel by way of farm products like vegetables, meat etc.
- It could be transported across borders by travelers (similar to traveler’s diarrhea) and on exports and imports.
- Transferred by infected patients from hospitals and back.
Spread of Candida Auris
- Candida Auris was 1st discovered in Japan in 2009.
- Now it has spread to almost all regions including South Korea, India, South Africa, Kuwait, Colombia, Venezuela, Pakistan, the United Kingdom, and the United States.
- Difficult to identify
- It can be misidentified for other types of fungi leading to wrong methods to arrest the spread.
- Low knowledge
- Current knowledge of the fungus is low
- Its origin,
- its spread,
- the way it affects,
- mechanism it adopts to develop resistance
- Rapid contamination of environment
- The fungus is so invasive that it spreads very rapidly in the hospitals and environment in general.
- The fungus is known to be resistant to 90% of the anti-fungal drugs
- Besides it is also 30% effective in case of multiple-drug therapies.
- Low attention
- Most of the attention among anti-microbial resistance is currently focused towards anti-biotic resistance.
Note on Traveler’s Diarrhea
- Traveler’s diarrhea is the other disease vulnerable to be transported across borders.
- The main reasons for traveler’s diarrhea are
- Changes in circadian rhythm
- Travelers moving across border witness changes in diet cycles, sleep cycles etc and thus affecting the life cycles of bacteria and viruses in the intestine.
- Contaminated environment
- Consumption of contaminated food and water in new destinations especially tropical countries like India is the main cause of diarrhea for travelers.
- The most common microbe causing diarrhea is E.coli bacteria.
- Delhi Belly is a case of traveler’s diarrhea caused by an infection in the intestine.
- Spread of infectious microbes
- Giardia is a common parasite vulnerable to spread across borders very easily through the travelers.
- Viruses also cause diarrhea and due to complexity in their lifecycles spread very fast across border through travelers.