The pandemic may favor the reappearance of the dangerous super fungus candida auris

Thanks to the coronavirus epidemic and the attention all focused on the emergency, the lethal superfungus Candida auris reappears with cases for the first time in Brazil. What do we know about the pathogen, a threat also for the future

Computer illustration of the unicellular fungus Candida auris, discovered in Japan in 2009 (Photo: Kateryna Kon / Science Photo Library)

The pandemic could be complicit in the new appearance of the superfungal lethal Candida auris, discovered just over 10 years ago, which fortunately has caused sporadic episodes so far. Two new cases of this very serious infection, which appeared in December 2020 in Brazil, have just been documented by researchers from the Federal University of Sao Paulo (Unifesp). The first two cases were detected in a hospital in Salvador, in the state of Bahia, and the clinical history of the patients was studied by a research team coordinated by Arnaldo Colombo of Unifesp. The results are published in the journal Journal of Fungi. Patients were hospitalized in Covid-19 wards: hence the possible link. L’Covid-19 alert by healthcare professionals around the world is very high and operators and hospitals are overloaded. The scientists’ hypothesis is that patients with severe Covid-19 may be more susceptible to developing fungal infections from Candida auris, until then silent, a pathogen to which they may have been exposed previously and with which they lived. What we know about the super mushroom and why it is good to keep your guard up.

A brief history of the super mushroom

The name certainly reminds us of something else: the super mushroom Candida auris in fact it belongs to the genus candida, some of which we know well some non-dangerous species, such as Candida albicans, with which it has nothing to do. But candida auris is quite another thing: the superfungus is associated with ahigh lethality, which also affects more than half of the cases, and fortunately few episodes are known worldwide. The threat lies in the fact that it is a new pathogen e resistant to the main categories of antifungals. The earliest strain of auris was photographed in a 1996 retrospective study from South Korea, while the earliest actual human case was identified. in 2009 in Japan, in the ear (hence the name auris, which in Latin means ear). There have also been cases in United States, where the first infection dates back to 2013.

Image obtained with the fluorescence microscope showing the structure of Candida auris (photo: João Nóbrega Almeida Júnior / Unifesp)

The danger of Candida auris

The superfungus can be present in the blood and cause systemic infections that are very harmful to the body. The risk is therefore not that of a simple candidacy at the local level but of one invasive and generalized candidiasis, similar to the sepsis bacterial that scares us so much. The other problem is According to the evidence gathered so far, about 60% of people affected by this fungus it encounters death.

Infections in the hospital

Affected patients in Salvador, Brazil were both hospitalized in Covid-19 departments intensive care. The theme of hospital infections it is gaining increasing attention and somehow, even if it seems paradoxical, advances in medicine and technologies could play a role, a bit like the other side of the coin. In the face of the undisputed benefit against various pathologies, the use of latest generation therapies and devices, in fact, it could lower defenses of the organism favoring its attack by various pathogens, including these fungi. We are talking, for example, of drugs such as corticosteroids or antibiotics, often also used in the case of coronavirus Sars-Cov-2, which can affect the intestinal microbiota and devices such as the central venous catheter that allows easy access to the main venous blood vessels. In specific situations, explains the author Colombo, the patient can become more vulnerable to candidiasis.

Beware of new mushrooms

For this reason, and for some years now, experts have been working to detect early and carry out continuous monitoring of these cases and the Brazilian group has so far detected new fungi but not Candida auris, appeared only now. Currently they have been described five subgroups of Candida auris and the one found in Brazil more closely resembles a type previously discovered in Asia and not so much to that in Venezuela and other South American countries. The data suggests that the mushroom came here not from America or that alternatively there is an origin, a local source. Scientists are now studying the use of antifungals in increasing doses to understand how to attack Candida auris. Even one correct diagnosis it is very important, as Columbus points out, to confirm its presence without confusing the mushroom with other candida species it is not easy with conventional instrumentation. In particular, a mass spectrometry technique must be used, i.e. the matrix-assisted laser desorption / ionization, indicated by the acronym Maldi.

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