There’s a new killer on the block, one you have probably never heard of, but you will.
It’s called Candida auris, or C. auris, and it is a drug-resistant fungus that has quietly spread around the globe, popping up in the past few years in more than 20 countries, including the United States.
Combined with bacterial infections, one British study projects that “10 million people could die worldwide of all such infections in 2050, eclipsing the eight million expected to die that year from cancer” unless policies are put in place to slow the rise of drug resistance, the New York Times reported this month.
The problem with C. auris is that it is resistant to treatment by antifungal medicines and is difficult to eradicate from health care facilities with current cleaning methods. Like bacterial infections, fungal infections are most lethal to people with immature or compromised immune systems — newborns, the elderly, smokers, diabetics and people with autoimmune disorders who take steroids.
It can be colonized — carried on a patient’s body but not causing them to be sick — but if becomes invasive and infects the bloodstream, C. auris is deadly and nearly half the patients who contract it die within 90 days, according to the Centers for Disease Control and Prevention, the news report said.
In 2016, the CDC issued a nationwide warning on C. auris to hospitals and medical groups and has labeled it a “serious global health threat.”
“It is a creature from the black lagoon,” Dr. Tom Chiller, who heads the fungal branch at the CDC, told the Times. “It bubbled up and now it is everywhere.”
In the U.S., there have been 587 cases of invasive C. auris infections, with 413 in New York and New Jersey and 144 in Illinois — concentrated in the Chicago area. The Times report said that in Chicago 50 percent of some nursing homes have tested positive for the presence of C. auris and the fungus can grow on intravenous lines and ventilators.
Scientists have not determined why it has surfaced suddenly across the world — in Spain, Britain, the Netherlands, India, Pakistan and South Africa. Some researchers suspect it is related to the rampant use of fungicides around the world to prevent plants from rotting. Azole fungicides are used on all sorts of crops.
“On everything — potatoes, beans, wheat, anything you can think of, tomatoes, onions,” one British researcher said. “We are driving this with the use of antifungicides on crops.”
The theory is that azole fungicides have been effective in eliminating other fungi and C. auris — with its resistance to treatment — has suddenly prospered and filled in the vacuum.
The outbreaks have been shrouded in secrecy. Hospitals in Britain — where an outbreak caused one medical center to shut down its intensive care unit and rip out equipment and floor and ceiling tiles — and Spain made no announcements of the health threat. Critics say the secrecy was motivated by hospital fears of driving away other patients.
The CDC needs to step up its work to limit the spread of the deadly fungal infections. Hospitals and nursing homes here need to ramp up detection and cleaning methods that identify C. auris and remove it. Pharmaceutical companies need to develop more effective antifungals to treat C. auris. Fungicide manufacturers must develop products to address this rising outlier. There are things that can be done.
The problem is in its infancy, but the threat is a serious one and the time to address it — across the board — is now, before it combines with bacterial infections to become America’s new cancer.