After the coming of hospital’s contracted diseases such as C. difficile or MRSA (Methicilin-Resistant Staphylococcus Aureus), another difficult to treat bug seems to emerge. This time, it is a fungus: Candida auris.
This fungus or more precisely this yeast, has first been discovered by scientists in 1996. Then, a first infected human case has been reported in Japan in 2009. 1,2 To this date, Candida auris has been detected in hospitals of more than 20 countries such as the United States of America, England and many Europe countries. The first case in Canada has been reported in 20173.
Candida auris poses a specific threat because of the following characteristics4:
- Infections by this microorganism have a high mortality rate.
- The microorganism resists antifungal agents.
- The microorganism is difficult to identify in clinical microbiology laboratories which results in wrong diagnostic. The identification is important in the choice of antifungal treatment.
- The microorganism is known for its virulence.
- The microorganism colonizes surfaces such as catheters used for healthcare.
Among recommended precautions by American and Canadian governments, disinfection of surfaces plays an important part. However, specific disinfectants are to avoid: this is notably the case for quaternary ammonium-based disinfectants which are ineffective5. The following procedure is rather recommended:
« Healthcare facilities that have patients with C. auris infection or colonization should ensure thorough daily and terminal cleaning and disinfection of these patient’s rooms with hospital-grade disinfectant effective against Clostridium difficile spores. »6
Sporicidal sodium hypochlorite-based disinfectant against C. difficile are for example great disinfectants to prevent and control contact transmission of Candida auris. In other words, scientists are only starting to understand and study this recently discovered microorganism. More studies will allow the discovery of effective treatment.
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1) Lee WG, Shin JH, Uh Y, Kang MG, Kim SH, Park KH, et al., (2011), First three reported cases of nosocomial fungemia caused by Candida auris. J Clin Microbiol, 49:3139-3142.
2) Satoh K,Makimura K, Hasumi Y, Nishiyama Y, Uchida K, Yamaguchi H., (2009), Candida auris sp. nov., a novel ascomycetous yeast isolated from the external ear canalof an inpatient in a Japanese hospital. Microbiol Immunol., 53:41-44.
3) Schwartz IS, Hammond GW., (2017), Premier cas de Candida auris multirésistant au Canada. Relevé des maladies transmissibles au Canada., 43(7/8):168-72.
4) Anuradha Chowdhary, Cheshta Sharma et Jacques F. Meis., (2017), Candida auris : A rapidly emerging cause of hospital-acquired multidrug-resistant fungal infections globally, PLoSPathogens, 13(5):e1006290
5) Institut National de Santé Publique du Québec, (Janvier 2018), Mesures de prévention et de contrôle dans les milieux se soins, Comité sur les infections nosocomiales du Québec, 2377 :1-11
6) Relevé des maladies transmissibles au Canada, (juillet 2017), Premier cas de Candida auris déclaré au Canada, Agence de santé publique du Canada, 43-7/8