“Cordyceps”. The fans of The last of us know its name, and the ravages of this parasitic fungus that has decimated humanity. While this is obviously fiction, Cordyceps does exist in reality, but potentially only attacks insects and other spiders, not humans. Unlike Candida auris which does indeed attack humans.
In the United States in particular, this microscopic fungus has been the source of several outbreaks of contamination in hospitals in recent years, prompting the Centers for Disease Control and Prevention (CDC) to launch an alert a few days ago on “the growing threat” that he represents. This potentially deadly fungus has been the source of contamination in Europe and France in recent years. However, in France, should we be worried?
What is Candida auris and what symptoms does it cause?
It is a fungus belonging to the Candida family, like Candida albicans, naturally present in the body and responsible for fungal infections. But Candida auris is not usually present in human flora. These are yeasts, unicellular fungi, which can cause different symptoms depending on where you become infected. “Candida auris can in particular cause an infection of the blood, a wound, the ear, the urinary tract, the bones or the meninges (envelope of the brain)”, detail the Quebec authorities. It was identified for the first time in Japan in 2009, during a sample taken from the ear canal of an infected patient, hence the name “Candidas auris” (candidiasis of the ear in Latin).
And the symptoms vary depending on the condition of the infected people. A healthy person can be a carrier and show no signs of infection. However, this fungus is dangerous for people with weak immune systems, in whom it can cause serious infections and lead to death. The World Health Organization (WHO) thus estimated, in 2022, its mortality rate between 29% and 53% for cases of invasive infections, ranking this fungus at the top of its list of 19 priority fungal pathogens.
Why does he worry the health authorities in the United States?
If Candida auris worries so much across the Atlantic, it is precisely because it is virulent in the most vulnerable people and mainly occurs in hospitals, which makes it a particularly serious nosocomial disease. “Individuals who are very ill, who wear invasive medical devices, or who stay frequently or long in healthcare facilities, are at increased risk of contracting it,” the CDC says.
Another major source of concern, “it is resistant to several antifungal drugs commonly used to treat Candida infections, underlines the CDC. Some strains are resistant to all three classes of antifungals available’, rendering all treatments ineffective. In addition, “it is difficult to identify with standard laboratory methods, and it can be misidentified in laboratories without specific technology,” the CDC continues. And misidentification can lead to inappropriate management.” However, the fungus “has caused epidemics in health establishments”. In the United States, “the cases detected tripled from 2020 to 2021, for a total of 4,041 contaminations identified”, indicates the CDC.
Is there a way to stem its spread?
For the CDC, the priority is “screening. It is important to quickly identify Candida auris in a hospitalized patient so that healthcare facilities can take precautions.” “The rapid increase and geographic spread of cases is concerning and underscores the need for continued surveillance, expanded laboratory capacity, faster diagnostic testing and adherence to infection prevention and control. proven,” insists Dr. Meghan Lyman, epidemiologist and lead author of the CDC article.
A sanitary fight that also involves hygiene measures. “Candida auris is mainly transmitted by direct contact with the contaminated hands of a carrier or infected person, with those of nursing staff, or even by indirect contact with contaminated surfaces and objects”, recall the Quebec health authorities. Hand and surface hygiene are therefore valuable tools.
Should we be worried about Candida auris in France?
In Europe, 327 cases were identified between 2019 and 2021 in five countries including France, reports Eurosurveillance, the European journal dedicated to the surveillance, epidemiology, prevention and control of infectious diseases. In France, to date, only six cases have been brought to light.
And the way forward is well defined. “Any suspected or confirmed case must be the subject of an internal and external report, and the strains must be sent to the National Reference Center for Invasive Mycoses and Antifungals”, recalls the High Council of Public Health.