What is candida auris, the deadly fungus that infected a man in Milan

Over there Candida auris
the “killer mushroom” that infected and killed a man admitted to Sacco Hospital in Milan for a stroke is a highly contagious pathogen and it can kill frail, elderly and newborn patients within three months. According to a report from the Annals of Internal Medicine
cases almost doubled (+95%) between 2019 and 2021 and among the cases studied, those resistant to available drugs tripled. In October 2022, the World Health Organization listed Candida auris as a high priority pathogenic fungi because it is a serious threat to public health by his resistance to a lot antifungal medications.

Isolated for the first time in 2009

The fungus was first isolated in Japan in 2009 from a sample from a woman’s ear (hence the name auris, ear in Latin). However, the earliest known specimen to date dates from 1996 and was retrospectively identified in a collection of Korean specimens. The first European outbreaks occurred in spring 2015 in France. In Italy, the first case of an invasive infection was recorded in 2019, followed by an outbreak that affected the northern regions (especially hospitals in Liguria) in the 2020-2021 pandemic period.

High mortality

The pathogen has a mortality ranging from 30% to 70%: if adequate therapy is not followed, it can provoke serious infections especially in multipathological individuals, because it is resistant to at least one of the three available classes of antifungal drugs, the echinocandins.

Highly contagious pathogen

The fungus is also very contagious: it is transmitted through contact with an infected person (candida auris can colonize the skin for several months) but also by the contaminated surfaces on which it can live for a long time
. And it is difficult to eradicate because, as written, it is resistant to common antiseptics. But how does candida auris resist drugs? The cause must be sought in the way it reproduces itself: by recombining itself, it generates new variants. If the strains that merge have developed resistance to two different drugs, the resulting variant will be able to resist the two drugs, and so on. Candida auris can be cause of hospital outbreaks difficult to control precisely because it resists mattresses, tables, bedside tables, beds, medical devices in an environment where patients are hospitalized for other pathologies. Not all commonly used disinfectants are effective against this dangerous fungus.

Complex diagnosis and generic symptoms

Candida auris is not easy to identify because infections are diagnosed by culturing blood or other bodily fluids. However, in tests it can be confused with other types of Candida and specialized laboratories are needed to confirm the diagnosis. THE symptoms they are too very generic because those affected are often patients with many other diseases. Linfection can remain silent for a very long time and become invasive only in a moment of lowering of the infected patient’s immune defenses. Among the most common symptoms, as reported by the Istituto Superiore di Sanità, there are cases of otitis media, wound infections, blood infections and infections affecting the abdominal organs. .

The role of global warming

The increase in the number of cases of fungal infections would be one of the consequences of global warming for our health: the rise in temperatures would favor the right conditions for the fungus to adapt to humans. Another piece of evidence against climate change is the fact that the ability of Candida auris to infect humans showed up simultaneously on three continents, America, Africa and Asia, in different strains.