COVID-19 may promote the spread of drug-resistant ‘superfungus’

Medical News Today recently reported on an emerging outbreak of a drug-resistant fungus in Brazil, and more broadly, the Americas. The fungus, Candida auris (C. auris), can cause infections in the bloodstream, wounds, and the ear. Since its emergence in the Americas in 2016, C. auris is a growing concern because of its rapidly evolving resistance to available anti-fungal drugs and its lack of sensitivity to disinfectants used in the healthcare setting.

Dr. Arnaldo Colombo, M.D., Ph.D, is leading the research on C. auris in Brazil at the Federal University of São Paulo. In the paper published in the Journal of Fungi, researchers estimate that “superinfection by C. auris in critically ill patients with COVID-19 is estimated to have a 30-day mortality rate of above 50%.” Furthermore, Dr. Colombo has reported that since the paper was published, the most recently collected samples of C. auris now take a four to five times larger dose of the anti-fungal fluconazole to inactivate the cultured cells.

Scientists at the CDC believe that the COVID-19 pandemic created the ideal conditions for the rapid spread of this fungal infection. Dr. Meghan Marie Lyman from the CDC’s Mycotic Diseases Branch told Medical News today that “during the COVID-19 pandemic, there has been an increase in C. auris cases, particularly in some areas of the United States that had not previously had many cases,” including California, New York and Illinois. She believes this could be due to changes in infection control practices during the pandemic, including the reuse of gloves and gowns, as well as the use of adjunct medications that suppress immunity to other infections and kill bacteria in the gut and on the skin.

Because both C. auris and COVID-19 impact a similar patient population, particularly those in long-term care facilities, essential routine screening has been limited because resources have been diverted to the COVID-19 response. Moreover, specialized laboratory equipment is needed to distinguish C. auris infections from other Candida infections, meaning C. auris cases likely go undetected and are more widespread than currently believed.

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