Candida auris is a yeast fungus that was first detected in the external auditory canal of a 70-year-old female patient in Japan in 2009. Hence its name: Auris is the Latin word for ear. Since its first appearance, this yeast fungus has already infected hundreds of people worldwide, primarily in hospitals. It has led to infections of the urinary tract, wounds and blood poisoning. Unlike the classical Candida yeasts, Candida auris is resistant to many conventional antifungal drugs. This is rather unusual for fungi and makes the pathogen difficult to treat. There are few antifungal drugs (medications for fungal infections) available to treat affected patients. In January 2018, this pathogen was detected for the first time in Austria by AGES. A patient in Styria had consulted a general practitioner due to a long-lasting inflammation of the auditory canal, who sent an ear swab to AGES for examination for microbial pathogens. The Austrian patient was successfully treated. The first Austrian description was published in the American journal Emerging Infectious Diseases.
In Europe, according to the European Centre for Disease Prevention and Control (ECDC), a total of 620 cases have been reported in seven countries since 2013 (Spain, United Kingdom, Germany, France, Belgium, Norway, Austria). Three quarters of these cases were harmless colonisations; in one quarter, however, the pathogen caused blood poisoning or other infections. Probably also due to improved diagnostic methods, significantly more cases were identified in 2016 and 2017 than in previous years.
In April 2018, the ECDC designated the occurrence of Candida auris as a Europe-wide risk for hospital patients. This is justified by the tendency of this new pathogen to cause outbreaks in hospitals, its resistance to conventional antifungal agents, and laboratory diagnostic problems (correct pathogen detection with classical methods [biochemical methods] not always possible). The largest nosocomial outbreak to date (= transmission in hospital) occurred in 2015/2016 in a cardiac surgery department in London.
The US health authority CDC (Centers for Disease Control and Prevention) estimates that between 30 and 60 percent of all infections in which Candida auris enters the body are fatal. The agency first warned of a serious global threat in August 2017. The CDC also cites the multidrug resistance of the new pathogen, the difficulty of correctly identifying the fungus in the laboratory using classical detection methods, which in turn can delay correct diagnosis and thus correct treatment, and the propensity of Candida auris to cause hospital outbreaks.
Other yeasts that colonize humans, such as Candida albicans, often reside on the skin and mucous membranes. They do not cause problems there. It is only when the immune system is weakened for some reason that they sometimes multiply to such an extent that corresponding signs of illness can occur - for example candidiasis, also known as thrush. Even in the case of Candida auris, colonisation of a healthy person does not primarily have any further effects. However, if there are pre-existing diseases, Candida auris can lead to symptoms such as blood poisoning, urinary tract infections or wound infections. While classical Candida albicans infections are endogenous infections (the pathogen originates from the body's own flora), Candida auris is passed on from person to person and via contaminated surfaces, which explains the described hospital outbreaks. Transmission most likely occurs as a smear infection. Airborne infection, as is often the case with cold viruses, can be ruled out according to current knowledge.
Dr. Shiva Pekard-Amenitsch
- +43 50 555-61210