Should I worry about the deadly fungal infection?
Anyone watching the popular TV show “The Last of Us” might have a healthy fear of fungal infections, and rightfully so since the show’s plot is about the fungus causing the zombie apocalypse.
Even more terrifying is the mechanism of fungal spread where the host loses all control of their body and the fungus takes over the host’s brain forcing the host to do whatever the fungus wants.
These infections aren’t that. Patients and clinicians should still be worried about multi-drug-resistant organisms since they pose a real threat, but there is no mind control or viral spread that would blanket the world.
The fungal infection being referenced by most news outlets is caused by Candida auris and the reason for alarm is due to the high mortality in patients that get it as well as the lack of treatment options.
C. auris is not a threat to healthy people. Patients with functional immune systems can generally clear the fungus on their own, but patients that are immuno-compromised are highly susceptible, and C. auris does kill 1 out of 3 people that become sick from it.
The reason for the high mortality is three-fold: C. auris is highly resistant to antifungals, it can be hard to identify so it is sometimes misidentified and therefore mismanaged, and it has caused outbreaks in healthcare settings where it spreads quickly among vulnerable patients.
Normally a sick patient would go to the hospital and receive antifungal medications that would clear the infection from a patient’s body, but some strains of C. auris are resistant to all three classes of antifungals.
The class known as the echinocandins are the only class that is left for treatment according to the CDC. This includes three medications called anidulafungin, caspofungin and micafungin. And while testing is being done to see if a combination of two or more antifungals will work to clear the infection, the regiment has not been tested in a clinical setting.
Worse yet is that even after a patient has been treated for the infection, C. auris generally remains on the patient’s skin and habitus for a long time, perhaps forever. Therefore, isolation precautions need to be taken so that it does not spread to other patients which can make nursing home and long term care placement difficult for patients.
Inevitably we want to know what can be done to solve the problem but the answer is not easy or fast. When it comes to drug-resistant bacteria and fungal infections, we are at the mercy of pharmaceutical companies to develop new antibiotics and antifungals. These are expensive and time consuming, usually taking several years to come to market. Therefore, staying healthy and taking care of yourself is the best thing you can do at this time.
Looking forward, it is important to remember that many medications were discovered in our natural environment; think of the mold penicillin that grew on a petri dish, digoxin from the leaf of the foxglove plant, or even morphine from opium. Our best sources of medication have come from nature itself. So if we want to hold on to hope for the future, the best thing we can do is be environmentally conscious and protect biodiversity in the hope that someday we may discover an unknown treatment from a plant or animal that could treat something like C. auris.
