Dental Tribune America

Centers for Disease Control and Prevention release statement on spread of Candida auris

By Dental Tribune International
January 23, 2020

NEW YORK, U.S.: In 2019, the Centers for Disease Control and Prevention (CDC) released a statement declaring that Candida auris is an emerging fungus that presents a serious global health threat. One of the main reasons that CDC released the statement was because C. auris outbreaks had occurred in health care settings.

After C. auris was first isolated from the ear of an elderly patient in Japan in 2009, infections have been recorded in more than 30 countries. The most recent outbreaks have taken place in Venezuela, South Africa, the U.S., Spain and England. According to CDC, as of November 2019, a total of 950 confirmed cases in the U.S. have been reported.

It is commonly found in older or sick patients, and more than a third of those who contract the fungal infection die within a few months, reports CDC. This risk to patients who may already be suffering from another illness is increased by the fungus’s ability to survive the type of industrial cleaning that may take place in the hospital room where a patient with C. auris was cared for. This makes it easier for it to be passed on in health care settings.

In a 2018 study, titled “Surface disinfection challenges for Candida auris: an in-vitro study,” Prof. Gordon Ramage from the University of Glasgow Dental School showed that C. auris was able to selectively tolerate clinically relevant concentrations of sodium hypochlorite and peracetic acid in a surface-dependent manner.  The discovery is something that researchers noted “may explain its ability to successfully persist within the hospital environment.”

Speaking to Dental Tribune International, Ramage said, “Unlike many other Candida species, there are high levels of pan-fungal resistance. Dentally, this may mean that azole and polyene drug resistance could feasibly be found in some strains associated with the oral cavity, thereby reducing our therapeutic options.”

Speaking about the threat C. auris poses in the dental setting, Ramage explained that there is no greater threat than that posed by any other oral Candida species. “We are yet to have any understanding of how they behave in complex biofilm communities like those that exist in the oral cavity. Like other Candida species, they could become invasive in patients undergoing surgical procedures. Their main issue could be resilience in the dental clinic, and studies have shown them to persist in the health care setting and from here can spread patient to patient.”

In a 2019 New York Times article, it was reported that, after a patient with C. auris died at Mount Sinai Hospital, the fungus lived on. According to the article, tests showed that the fungus had spread throughout the entire room where the patient had been cared for, and the hospital needed to remove some of the ceiling and floor tiles to eradicate it. “Everything was positive—the walls, the bed, the doors, the curtains, the phones, the sink, the whiteboard, the poles, the pump,” said Dr. Scott Lorin, the hospital’s president.

However, despite the threat that it poses, Dr. Robert H. Shmerling, a faculty editor for Harvard Health Publishing, believes that it is not time to panic. In an article titled “The latest deadly superbug—and why it’s not time to panic,” Shmerling said that the drug-resistant fungus was a cause for concern, but that there was more that needed to be known. Healthy people rarely contract the infection, and Shmerling believes that the best way of dealing with this latest superbug is by taking basic precautions, such as the proper washing of hands.

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