Deadly Super-Fungus Traced to a Covid-19 Intensive Care Unit in Brazil

Candida Auris, a lethal yeast, was discovered in Brazil for the first time late last year. According to a new article published this week, the scientists who treated and analyzed these early cases claim the covid-19 epidemic helped establish a breeding habitat for the fungus to sprout and spread inside a hospital’s intensive care unit.

C. Auris was originally found in 2009 by Japanese doctors, but it has most likely been infecting individuals since the 1990s. Its origins are unknown, but the most popular belief is that it only lately started causing problems for people. The fact that yeast strains are typically (or quickly become) resistant to several antifungal medicines is what makes it so deadly. Fever and chills are common symptoms, but in more serious situations, it can infiltrate the bloodstream and several organs, causing organ damage and/or life-threatening sepsis. While not all infections cause illness, the yeast’s hardiness makes major infections extremely difficult to cure and often fatal, especially in patients who are already frail in hospitals or who are otherwise immunocompromised. Decontaminating the surroundings where the fungus colonizes outside the body, such as catheters or other medical equipment that provide an accessible path for infection, is also difficult.

Since 2019, C. Auris has been classified as an urgent superbug threat by the Centers for Disease Control and Prevention (CDC), and governments and hospitals worldwide have been on high alert for it. Brazil became the latest country to report finding it in December 2020. A recent report published on Monday described two of the first cases, both hospitalized for covid-19 in the same intensive care unit at a Salvador hospital.

The cases involved a 59-year-old man and a 72-year-old woman, both hospitalized with severe acute respiratory syndrome from covid-19 in October and November 2020, respectively, according to the article published in the Journal of Fungi. Other infections, including C. Auris, plagued the two individuals. Unlike previous outbreaks, however, this strain appeared to be responsive to a wide range of antifungals. Both diseases were treated, and the man recovered enough to be discharged after 49 days; unfortunately, the woman was not so fortunate, and she died in late January 2021 from her numerous ailments.

As of December 2020, public health officials had documented nine more persons with C. Auris invading their bodies, all of whom had attended the same intensive care unit as the first cases. The cases appear to be linked to a local source, as none of the patients have recently traveled and their fungus is closely related to one another. The authors currently believe that the fungus arrived or emerged locally months before the first instance. While this strain appears to be curable with standard medications, samples isolated from these patients have begun to become resistant to at least some antifungals over time.

C. Auris outbreaks in covid-19 patients have lately been observed in several countries. And in this outbreak, the acute illness caused by covid-19 and the subsequent hospitalization certainly allowed the colonizing fungus to become life-threatening and infect more sick people, a scenario that could be repeated elsewhere.

The authors speculate that “the covid-19 pandemic may be accelerating the introduction and/or spread of C. Auris in previous C. Auris-free hospital environments.”

C. Auris isn’t the only fungus associated with covid-19 that has doctors concerned recently. During the pandemic’s most recent and most lethal phase in India, incidences of black fungus, a micromycetes-related infection that is generally exceedingly rare, began to rise, with roughly 12,000 cases reported in the country during the past few months. This illness, like C. Auris, can be extremely deadly once it infects hospitalized patients, killing up to half of those who contract it. It’s not just covid-19 that’s causing these outbreaks; it’s also its main treatment: steroids, which suppress the overactive immune response while also making us more prone to fungus and other bacteria.

All of these cases serve as a stark reminder of the direct and indirect toll that covid-19 has taken, a toll that is likely to continue for the foreseeable future in nations where covid-19 vaccines and other preventative measures are in short supply. Although India’s peak has passed, Brazil continues to see many new cases and deaths. With the advent of more transmissible forms like Delta, which was originally discovered in India, the world as a whole remains exposed to new peaks of sickness, bringing with them other nightmares like C. Auris. Only about 15% of the world’s population has received even a partial vaccination.

Public health officials are still looking into the strain of C. Auris detected in these Brazilian cases, which appears to be the first local occurrence of a particular subtype of the fungus Clade I in South America. The goal is that by figuring out how it first appeared and why it differs from prior strains, scientists will better prevent its spread in the future.