Candida Auris: Deadly drug-resistant found in India that can lead to next pandemic

Already the whole world is suffering from the COVID-19 pandemic and governments are still finding solutions to tackle it till then a piece of new news related to other pandemic is in the air.

Recently, the Candida Auris, a deadly hospital pathogen for the first time identified in the environment of the coast of the South Andaman district in the Andaman and Nicobar Islands.

Candida Auris is a multidrug-resistant “superbug” whose traces are found on remote sandy beaches of India that can lead to the next deadly pandemic.

Regarding this, the study was carried out by the Vallabhbhai Patel Chest Institute, Delhi in collaboration with the Department of Ocean Studies and Marine Biology, Pondicherry University.

What is Candida Auris?
Candida Auris is also known as C.Auris. It is a multidrug-resistant drug pathogen that is considered at present “a serious threat to human health” as per the US Centers for Diseases Control and Prevention.

As per the researchers, Candida Auris belongs to the Candida haemulonii clade of the Metschnikowiaceae family of the order Saccharomycetales.

Metschnikowiaceae family-related species have been detected in plants, insects, and aquatic environments, as well as from human body sites.

It is an emerging fungus and due to three reasons CDC is concerned namely;
1. As said above it is multidrug-resistant that is it is resistant to multiple antifungal drugs commonly used to treat Candida infections. In fact, some strains are resistant to all the three available classes of antifungals.
2. With standard laboratory methods, it is difficult to identify and can be misidentified in labs without specific technology. Also said that misidentification may lead to inappropriate management.
3. It has caused outbreaks in healthcare settings. Therefore, it is important to quickly identify C.Auris in a hospitalised patient so that healthcare facilities can take special precautions to stop its spread.

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About the Research
The research or study that is carried out in the Vallabhbhai Patel Chest Institute has for the first time established that the fungus found in the tropical marshes and marine environments outside hospital environments.

The team of researchers have collected 48 samples of sediment soil and seawater from eight sampling sites across the east and west coast of the South Andaman district.

C.Auris was isolated from two of the eight sampling sites namely a salt marsh and a sandy beach.

C.Auris two colonies were found at the salt marsh from the composite soil sediment.

22 colonies were found at the beach and these were distributed in both the sediment and water samples that are establishing the fungus in both marine and terrestrial.

According to Dr Anuradha Chowdhary, lead author of the research “Interestingly, both multidrug-susceptible and multidrug-resistant C.auris isolates were found in the sample. The fact that viable C.auris was detected in the marine habitat confirms C.auris survival in harsh wetlands. Fungi are present in the environment as degraders of organic matter. Fungi predominately thrive in tropical and subtropical areas.”

Also, Dr Chowdhary said that the drug-susceptible fungus, which can be treated with medication, can adapt inside the human body and become drug-resistant. This makes the pathogen difficult to treat.

It can be deadly for immunocompromised patients. And the incidence of patients dying from this fungal infection in India is less as compared to the countries like the US, UK, etc.

As per the research, patients in ICUs are found across the country. When the fungus enters the bloodstream is deadly or inhabits the body of a patient suffering from a serious disease like cancer.

What do previous theories say about the C.Auris?
The fungus might be native to wetlands and its emergence as a human pathogen might have been linked to warming effects on wetlands. Its thermal and salinity tolerance is due to the adaption to global warming which makes the human body more susceptible as a host. As most other fungi cannot flourish in the high temperatures inside the body. As per the experts, this theory also needs more investigation.

What are the Symptoms of Candida Auris?
1. It does not show any kind of symptoms before turning into fever and body chills. If these symptoms do not go away timely then it may lead to the death of the body they host in.
2. Candida Auris survives on the skin before entering the body through wounds.

According to the WHO, “Once in the bloodstream, it causes severe illness and can lead to sepsis which is a condition that kills up to 11 million people a year globally.”

According to the CDC, the microbe can also cause serious bloodstream infections mainly in patients who require catheters feeding tubes or breathing tubes.

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What type of infections are caused by C.Auris?
It can cause bloodstream infections, wound infections, and ear infections. It has also isolated from respiratory and urine specimens but it is still unclear that it causes infection in the lungs or bladder.

What causes C.Auris to spread?
How C.Auris spreads is still a mystery to scientists and researchers.
It is said that that it may spread in people who have been recently hospitalised or have a central venous catheter or other line or tubes entering their body or may have previously received antibiotics or antifungal medications. All these appear to be at a higher risk of infection with the yeast.

C.Auris specimens genome sequencing or testing in several countries of Asia, Africa and South America proved that it has emerged independently in multiple regions at the same time. CDC found that it isolates within each region and are quite similar to one another but are relatively different across regions.

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About the Previous traces of C.Auris
In 2009, it was first identified in a patient in Japan. Now the fungus has emerged in more than 40 countries across five continents in the last decade. As it is an emerging pathogen, so less information is available about the fungus so far.

How is C.Auris diagnosed?
As discussed above the fungus is not detected easily and can vary in symptoms. It is said that the infection can be diagnosed through blood cultures and the culture of other fluids. It can also be very confusing with several other common types of curable candida infections.

Why this is known as the next pandemic?
According to the report of Dr Sheppard from McGill University, Canada, the spread of C.Auris in several countries including the UK, USA and India in a short time is no doubt a cause of worry.

A report by Dr Donald Sheppard, a professor of microbiology at McGill University, Canada, in 2020, said that the evidence of C.Auris is present in the UK as the fungus have been found in the foot ulcers of people with diabetes in London has also been reported in India.

People who have travelled to the UK from areas, some random cases of the fungus emerging and C.Auris is more prevalent with multiple introductions from Asia and Africa.

Changes in temperature globally have also made the pathogen adapt to several hot conditions which further aids its survival in the human body. And its multidrug-resistant attribute adds to its survival rate and damage to human life. Therefore, it can be said as the next pandemic if any outbreaks occur.

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