Candida Auris, renamed in 2023 Candidozyma Auris, is a fungus resistant to drugs that spread rapidly in European hospitals, ECDC demanding urgent measures. It is very dangerous for patients already in serious condition, those who also have symptoms.
Patients in serious condition are the most exposed to the risks of infection with C. Auris Photo: AFP
The number of cases of Candidozyma Auris (former Candida Auris) is increasing, outbreaks are expanding, and several countries report continuous local transmission, warns the European Center for disease prevention and control (ECDC). The findings of the specialists – which emphasize the importance of early detection and transmission control to avoid rapid spread on a large scale – were presented in the latest study of the European Center for Disease Prevention and Control (ECDC), fourth.
Over a decade, between 2013-2023, EU/EEA countries reported over 4,000 cases, “with a significant increase in 1,346 reported cases by 18 countries in 2023 ”, is shown in a statement of the ECDC.
The number of registered and documented cases (the data for the study on C. Auris from 2024 were voluntarily transmitted by the National Micology Laboratories, together with the ad-hoc data collection in a subset of hospitals) represents only the peak of the iceberg, the specialists consider, because the systematic supervision does not exist in many countries.
Our country is part of Spain, Greece, Italy and Germany, in the countries that have registered most cases during the decade.
The recent study shows that the spread of C. Auris continued at a rapid pace in the EU/EEA countries. The first cases of C. Auris in the EU/EEA were reported in 2014, followed by the initial outbreaks and, more recently, by a constant increase until 2023, when 1,346 cases were reported by 18 countries. Despite the strong documented growth, the number of registered cases reflects only the tip of the iceberg, because systematic supervision does not exist in many countries.
Three countries (Cyprus, France and Germany) reported distinct outbreaks, while four countries (Greece, Italy, Romania and Spain) reported that it is no longer possible to distinguish specific outbreaks in a regional endemicity situation. In Italy, Greece and Spain the period between a first documented case in the country and the documented regional endemicity was five to seven, which shows why Candidozyma Auris (or Candida Auris, as I knew), resembles concern.
“The current rapid spread of C. Auris is a serious concern and indicates a high risk of continuous spread of C. Auris in European health systems. Given the increasing number of cases and their larger geographical distribution, sustained control will become more difficult. National efforts for early detection and rapid implementation of PCI measures (n. Red. – National Prevention and Control Guide to infections) to limit or delay the subsequent spread of C. Auris can still alleviate the impact on hospitalized patients ”is shown in the ECDE report.
Such a prevention and control guide of infections has only 15 out of 36 countries included, although the capacity of laboratories is comparatively stronger, 29 countries reporting access to a reference or expert laboratory, and 23 offering reference tests for hospitals. The national studies in the Netherlands and France have also demonstrated a limited training of hospitals and a limited implementation of national guides, ECDE shows.
Symptoms of Candida Auris infection. Why is it so dangerous
C. Auris infection has become a public health problem given that it spreads extremely quickly, can cause septicemia, wound infections or blood, and some stems are resistant to several drugs, which makes the infection difficult to treat.
Most commonly it spreads in hospitals or long -term care units and can cause ear, wound infections, urinary tract, or blood infections that spread in the rest of the body. The fungus can be taken from contaminated surfaces or from other people who have an infection with C. Auris.
It is truly dangerous to people who have pre -existing diseases, and can lead to death, while healthy people can only be carrier, without symptoms.
The symptoms of an infection with C. Auris depend on the place in the body where the fungus is located. These include: fever, chills, extreme fatigue, low blood pressure, high heart rate (tachycardia). Hypothermia (low body temperature), pain or pressure in the ear can be encountered (if the ear infects). Given that exposed in particular patients in serious condition, these symptoms, who are common to other medical situations, may not first raise the suspicion of such an infection.
Healthy people, on the other hand, who are only carriers, can carry on Candida Auris without having symptoms.
The risk of transmitting this fungus that produces concern is high in hospitals because the transmission can take place both from one person to another and through medical equipment or through a medical device (venous line, respiratory tube, etc.) Experts are of the opinion that C. Auris does not spread through air.
How can the spread can be prevented
Diagnosing infection with Candidozyma Auris (Candida Auris) can be quite difficult, requiring special tests. Things are not simple by analyzing the symptoms, which can also have various other causes. The alarm signal can be pulled when the doctor finds the symptoms of a bacterial infection that do not disappear under antibiotic treatment.
And the treatment is difficult, certain types of C. Auris becoming resistant to antifungal drugs, the variant being of combinations of drugs in high doses.
Much more handy is to prevent the spread of infections associated with medical assistance, including it. Hand washing is the first rule that, if respected as it is presented to the staff, could change the problem data. Disinfection of surfaces (Candida Auris can survive on surfaces in the hospital environment for days, weeks or even more), sterilization of medical devices and antibiotic administration only when there are bacterial infections (to prevent antibiotic resistance) are other measures that can be easily implemented.
To these are added those that are adopted when either the suspicion of a outbreak, or it has been confirmed: the screening of the patients and visitors of the medical units; quaranting (isolation) of people with infections with C. auris etc.
Romania, among the countries where the infection became endemic
Romania is among the five countries where the situation has become regional endemic. According to public data, this year several outbreaks of Candida Auris were reported in hospitals in our country, Bucharest, Bacău, Mureș, Cluj and Olt, only in Bucharest, in six reported outbreaks, 44 patients being affected.
From this infection associated with the hospital care, the scandal that led to the relegation of the Floreasca Emergency Clinical Hospital has left, when the patients for whom the family fought to transfer to a Belgium hospital made public that the patient left the Romanian hospital.
