Where do “super fungi” come from and where do they go?

Reviewer: Zhang Shuyuan, Chief Physician, Beijing Huayi Integrated Traditional Chinese and Western Medicine Dermatology Hospital

In recent years, "super fungi" have spread around the world.

It is reported that "super fungi" are prone to infecting people with low immunity, such as the elderly, smokers, diabetics, and newborns. There is currently no effective medicine to cure it. What is even more terrifying is that this pathogen is drug-resistant. In the past, when "super fungi" broke out, as many as 700,000 people died from drug-resistant bacteria worldwide.

So where did the "super fungus" come from? And how did it spread to humans?

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1. Discovery of “super fungi”

"Super fungus" refers to Candida auris, whose full name is Candida auris, which was found in the ear canal secretions of patients with ear diseases.

In 2009, it was reported abroad that a new species of Candida albicans was detected in the ear canal secretions of a 70-year-old patient who was treated for ear disease. The difference between this species and other species is that it can survive in an environment with a high temperature of over 42°C.

In the same year, another study isolated new bacterial species from the ear canal secretions of 15 patients with chronic otitis media, which had different resistance to antibiotics such as azole drugs and amphotericin B.

Some researchers discovered fungemia caused by Candida auris from this new species, and since then, Candida auris bloodstream infections have occurred in many countries around the world.

As of the end of 2020, cases of Candida auris infection have occurred in 44 countries and regions around the world. At the same time, Candida auris has been constantly mutating in order to survive over the past few years, and has gradually evolved into a "super fungus" that can resist a variety of antifungal drugs.

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2. What are the forms of infection of "super fungi"

1. Colonization infection

Colonization infection refers to the infection of an organ or part of the body. C. auris colonization has been detected in the armpits, rectum, nasal cavity, groin and in multiple body organs.

Because C. auris is highly contagious, colonization-type infection occurs primarily through contact with a patient carrying C. auris or with an infected environment.

2. Invasive infection

There are many manifestations of invasive infection, mainly external environmental infection, especially Candida bloodstream infection is the most common.

For example, contact with patients with ear canal germs or medical equipment carrying germs.

When receiving treatment in a hospital, the use of antibiotics can easily lead to infection by exposing the drugs to the external environment.

Various medical catheters, various contacts during surgery and hospitalization, especially long-term stay in the intensive care unit, can easily cause bacterial infection.

Although the "super fungus" is highly infectious, with the continuous development of medical technology, we don't need to worry too much as long as we take precautions.

3. “Super fungi” can be prevented

Candida auris is usually transmitted through medical equipment, hospital wards and the surrounding environment, and sometimes from person to person. To prevent its spread, cleanliness and environmental hygiene are particularly important.

1. Strengthen prevention and reduce infection

First, isolate patients infected with Candida auris in single rooms and implement strict isolation standards for those in contact with patients. This can prevent transmission between people.

Secondly, all environments and equipment that the patient has come into contact with must be strictly disinfected using cleaning and disinfection procedures.

If the patient needs to be transferred to another ward or medical department during treatment, the relevant medical staff must carefully communicate with the patient about the Candida auris carriage and infection symptoms in a timely manner.

If a patient is newly diagnosed with Candida auris, people who have had contact with them should be screened promptly to see if they have already been colonized.

Finally, any newly discovered case of infection, whether it is colonization infection or other forms of infection, must be carefully observed and followed up, as well as registered and recorded.

2. “Superbugs” are not incurable

Although Candida auris is highly contagious and resistant to some antibiotics, some antibiotics are still effective against some bacteria. If it is a mild to moderate infection, it can be treated with aminoglycosides, quinolones, fosfomycin, etc. alone, or with aminoglycosides combined with ciprofloxacin, ciprofloxacin combined with fosfomycin, etc. Therefore, don't worry too much about this bacteria being "incurable".

The treatment prospects for Candida auris are very optimistic. In 2018, a medical institution and experts from multiple disciplines launched a clinical diagnosis study of Candida auris, providing more possibilities for the diagnosis and treatment of "super fungi".

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The occurrence of "super fungi" is closely related to the abuse of antibiotics. It is often just a very common disease, but it is necessary to rely on antibiotics to achieve the purpose of rapid cure. This practice has led to the inadvertent spread of "super fungi". Therefore, in the face of common diseases, we must believe in our own immunity, use our own immunity, and cooperate with common drugs for the symptoms. Common diseases can also achieve good treatment effects.