A deadly fungus that is outsmarting major antifungal drugs is slowly spreading across the United States, causing doctors to infectious diseases in western Pennsylvania to prepare for its eventual arrival.
The fungus, Candida auris, was approved in New York and New Jersey, but no cases were reported in Pennsylvania, according to the US Department of Health. As of March, the Centers for Disease Control and Prevention reported 617 cases across the country.
"It's only a matter of time before we see these organisms spread," said Dr. Tom Walsh, an infectious disease specialist and medical director of quality at the Allegheny General Hospital in Pittsburgh. "We learn a lot from all the places they have."
Nate Wardell, spokesman for the Health Department, said health services were required to report an approved case. Also, he shares all the information with the NHS via regular network messages alerting her health, among others.
The CDC considers the fungus to be a "serious health threat". In addition to confirmed cases in 12 countries, more than 20 countries reported cases of Candida uris, according to data collected by the CDC.
"Mortality is very high," says Dr. Ames Adlya, a senior researcher at the Johns Hopkins Medical Center for Health and Physicians of Pittsburgh-based infectious diseases. "This microorganism is very challenging to deal with."
Adalja said that people at highest risk seem to have patients who already have a chronic illness or immune system being compromised, as well as patients already admitted to the health facility.
The fungus can cause infections in the blood, inflammation of the wound and ear infections, according to the CDC.
The fungus can be difficult to diagnose because conventional laboratory tests can lead to incorrect identification and inappropriate treatment, making it difficult to control the spread of Candida auris.
It is difficult to treat because it is often resistant to the most common antifungal drugs and is usually found in health settings – including hospitals and nursing homes – where it can spread rapidly. Some strains can be treated with high doses of multiple drugs, but some are completely resistant, according to the CDC.
Difficult to prevent
Adalja said there is not much average person can do to prevent the fungus out of normal hygienic practices such as handwashing. Often there are no symptoms until it has progressed significantly.
"Maybe you do not have symptoms when it's just colonization," he said. "It is difficult for the general public to take specific action."
Dr. Graham Snyder, Director of Pollution Prevention at UPMC, said that there is so much known about Candida auris, it's hard to know exactly what to expect.
"What's fascinating about this bug – and there's a lot more to learn – we do not know where it comes from," he says. "It appeared in different places in the world at the same time."
Snyder said it was hard to predict how it would continue to spread. Right now, this is usually found in health settings, but it may not always be so.
He points to MRSA as an example of a drug-resistant bug, which began only in medical facilities, but after several years began to appear elsewhere. Infections are now reported in places such as schools and among athletes who play sports with a lot of physical contact.
"It's very early in Candida Oris," Snyder said. "It's hard to give a person a tip to say, 'You have to do x, y, z to avoid Candida auris.'"
However, hospitals are preparing for the day when a patient with a fungus can be diagnosed.
Walsh said that Allegheny's health network began carrying out more comprehensive tests when the patient checks positive for each type of Candida to make sure they are not lacking in auris Candida. UPMC does similar tests.
Walsh said early identification was key because the sooner a patient was diagnosed, the more the hospital could be isolated and treated before it spread to other patients.
"It's a lot more work (but) we want to make sure we're ahead of it," he said.
Emily Blesser is a writer of the Tribune-Review. You can contact Emily at 724-226-4680, [email protected] or via Twitter .