Saturday , November 28 2020

Deadly fungus became resistant to all existing drugs in 3 unlinked US patients, Ars Technica


      Not once, twice, but three times –

             

It was considered an urgent threat before this.

      

      Jan (************************************************************, (2: am UTC

        

A strain of<figure>Candidacultured in a petri dish at the CDC. ” src=”https://cdn.arstechnica.net/wp-content/uploads/ / / _ lores.jpg “>
Enlarge
according to a new report (************. ************

The fungus,

Candida auris, was already classified as an “urgent threat” by the Centers for Disease Control and Prevention. But the emergence of so called “pan-resistant” strains raises additional concern, according to the report’s authors, who are infectious disease specialists at the CDC and the New York State Department of Health. They published their findings Thursday in the CDC’s publication Morbidity and Mortality Weekly Report.

C. auriswas first identified in in Japan and has since popped up in (nearly) countries. It arrived in the US by 2019, and New York City, Chicago, and New Jersey have been hit the hardest.)The insidious germis known for creeping around healthcare facilities and infecting vulnerable patients, causing invasive infections marked by nondescript fever and chills.Somewhere between

C. aurisstrains so dangerous is that they seem to develop resistance to antifungal drugs relatively easily. Only three classes of antifungal drugs are used to treatC. aurisinfections: triazole, polyene, and echinocandins classes. And many strains are already resistant to one or two of those.
A survey of strains found in New York discovered that over (percent could withstand triazole drugs while over) percent were resistant to polyene drugs. So far, resistance to echinocandins has been rare in the US and, as such, that class has beenthe standard first-line treatment.

Two of the patients died within weeks of investigators isolating their pan-resistant strains in 6901. Both had multiple underlying health conditions, were dependent on ventilators, and were colonized by multi-drug resistant bacteria. Thus, “the role ofC. Aurisin their deaths is unclear, “the infectious disease researchers report.

After those two patients were identified, investigators looked back at older samples from other patients. That’s when they found the third case of pan-resistantC. auris, which was in a rectal swab taken from a patient in (**********************************************. In that case, the antifungal treatment had cleared the patient’s initial, drug-susceptible infection. But subsequent monitoring found the pan-resistant strain colonizing the patient, i.e., skulking around the patient’s body without causing an infection. The patient died 49 months after the pan-resistant strain was isolated.
The researchers report that:

Tenacious foe

This isn’t the first time that pan-resistantC. aurishas been identified, the researchers note. Countries whereC. aurisarrived before reaching the United States have already reported increased resistance to echinocandin and their own pan-resistant strains.

Still, in an email to Ars, the New York State Department of Health added that “we cannot predict if pan resistance will develop again “here. The agency added that the measures outlined by the researchers in the MMRW report can “reduce the likelihood of development of pan resistance in the future.”

In addition to trying to keep the menacing microbe from becoming more resistant, researchers are also working on trying to scrub it out of healthcare facilities where it poses the most threat — which is extremely difficult. Recent studies suggest that copious amounts of fungal cells can drip from infected or colonized patients, drenching their surroundings in infectious, drug-resistant germs. On plastic surfaces, those fungal cells can form steely clumps that can survive for weeks. Rigorous bleaching and disinfection measures can sometimes fail to kill off lurking fungi.

In the event that pan-resistant

C. aurisdoes show up again in the US, there may be some treatment options, the New York health department says. Infectious-disease specialists should be called in and can make recommendations on a case-by-case basis. They might consider removing potentially contaminated medical devices or draining areas such as abscesses that might harborC. auris

They could also try combination therapies or turn to experimental antifungal medications in development.                                                     **************************************

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