Tuesday , May 18 2021

The germ on the drug is spreading quietly all over the world




Deep Cleansing Techniques at Mount Sinai Hospital in New York Credits: NYT

Candida auris, recently discovered, was found in several countries; can cause death for 90 days

In May last year, an older man entered a hospital on Mount Sinai on Mount Sinai for abdominal surgery. Blood tests have revealed that it is infected with newly-discovered, deadly and mysterious beats. The doctors immediately isolated it in the intensive care unit.

Sprouts, called mushrooms
Candida auris, encourages people with a weakened immune system and is spreading quietly around the globe. Over the past five years, he has ruined a neo-National unit in Venezuela, wrecked a hospital in Spain, forced the closure of the intensive care unit at a prestigious clinic in Britain and rooted in India, Pakistan and South Africa.

And recently
Candida auris He also arrived in New York, Illinois and New Jersey, forcing the United States Control and Disease Prevention Center (CDC) to add it to a list of germs that are considered an "immediate threat."

The old man who was admitted to Mount Sinai in Brooklyn died after 90 days at the hospital but
Candida auris She survived. Analyzes showed that his room was completely affected by the stroke, to the extent that the hospital had to use special cleaning equipment and even replace part of the ceiling and floor tiles to eradicate it.

"Everything was positive: walls, bed, doors, curtains, phones, toilets, tubes, valves," says Dr. Scott Lorin, hospital director. "Mattress, barrales beds, containers, shutters, ceiling, absolutely everything that was in the room was positive".

Candida auris It is so difficult to eradicate because it is immune to most antifungal drugs, which turns it into a new example of the most serious health threats: an increase in drug-resistant infections.

Prior to decade, public health experts warn that antibiotic abuse reduces the effectiveness of drugs that have prolonged life expectancy due to their ability to treat bacterial infections that were once deadly. But lately there has also been an explosion of resistant fungus, adding a new and frightening dimension to the phenomenon that undermines the pillars of modern medicine.

"This is a very serious problem, because we are dependent on antifungal drugs for the treatment of these patients," says Matthew Fisher, professor of fungal epidemiology at Imperial College London, a co-author of a recent scientific report on increased fungal resistance.

In short, fungi, like bacteria, develop defense that makes them immune to contemporary drugs.

And antibiotics and fungicides are essential in combating infections, but antibiotics are also widely used to prevent the disease of domestic animals, and fungicides are also being used to prevent plant rupture. Some scientists have found evidence that growing growth in fungicide use in crops increases the growth of fungal resistant fungus affecting humans.

And although the problem is increasing, public opinion is almost unknown, partly because only the existence of resistant infections is usually covered by the mantle of secrecy.

Hospitals and local authorities are reluctant to detect infectious phenomena of bacteria and fungi alike in fear of being seen as a source of illness. Even CDCs, under the terms of an agreement with the US, should not publish the name and exact location of the hospitals in which an epidemic has been reported. In many cases, state authorities refuse to publicly divide this information and are limited to recognizing such cases.

Meanwhile, the sprouts spread widely: from hand to arm hospital staff and equipment, transportation of meat and vegetables from villages, travelers crossing borders, import and export, and patients. they enter and exit the hospital.

example

Candida auris it's just one example of dozens of fungi and dangerous bacteria that have already developed resistance. However, as well as the rest, the public remains almost unknown.

There are other known strains
Candida – one of the most common causes of hospital infections – that did not develop significant drug resistance, but more than 90% of infections
Candida auris they are resistant to at least one drug, and 30% are resistant to two or more drugs, says the CDC.

Dr. Lynn Sosa, deputy head of epidemiology at Connecticut, says she is currently
Candida auris it is the "major" threat between resistant infections. "It's practically unbeatable and very difficult to identify," the official says.

Almost half of the patients who are decreasing
Candida auris according to the CDC, die within 90 days. However, world experts have failed to find out where it originally came from.

"It's a monster in the black lagoon," says Dr Tom Chiller, head of the CDC fungal disease department, who runs the world's detective initiative to find the appropriate treatment and halt the spread of fungi. it exploded. "

Where does it come from?

While the CDC works to limit the progress
Candida auris, his researchers are trying to deconstruct the disturbing question: from which part of the world comes?

For the first time, physicians encountered fungus in Japan in 2009 (
Auris in Latin means the ear). At that time it seemed harmless, a cousin of one of the many fungal infections that can easily be treated.

Three years later, an unusual result of laboratory analysis was conducted by Dr Jacques Meis, a microbiologist from Nijmegen, the Netherlands, who analyzed blood infections in 18 patients from four hospitals in India. Very fast and for several months new launches
C. auris have begun to appear in different parts of the world.

The CDC researchers had the theory that it was
C. auris It was born in Asia and spread all over the planet. But when the agency compared the complete sample genome
C. auris from India, Pakistan, Venezuela, South Africa and Japan, they found that they did not originate in one place and that there was no single soy
C. aurisSomehow it did almost this time, and it seemed to spread and is now drug resistant, something really confusing, "says Dr. Snigdha Vallabhaneni, a key member of the CDC team of researchers.

There are different theories about what might happen
Candida auris, Meis, a Dutch researcher, believes fungus has become resistant to drugs due to the intensive use of fungicide in crops.

Meis became interested in resistant fungus when he heard about a 63-year-old Dutch patient who died in 2005 of fungus known as
Aspergilluswhich proved to be resistant to the most recent antifungal drugs called itraconazole. The drug is basically a copy of azole pesticides used to spice crops around the world and represent more than one third of total fungicide sales.

Dr. The chiller, from the CDC, has the theory that it is
C. auris perhaps intensified by the use of fungicides. He believes that fungus exists for thousands of years, hidden in the corners and cracks of the world, and is not a particularly aggressive pest. But when azole fungicides started disinfecting the most common fungi
C. auris He found his chance to gain ground because of his ability to withstand fungicides in a world where less resistant fungus was attacked.

Origin
Candida auris Mystery remains, but for a moment less important than slowing down its progress.


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