2024-05-03 12:46:16
As early as the beginning of 2023, the US Department of Health warned about the fungus Candida auris – a pathogen. Now the numbers are also increasing in Germany.
The fungus and pathogen Candida auris, discovered only a few years ago, is spreading rapidly in Germany. In 2023 it was detected 77 times nationwide – that was six times more common than in previous years, according to the evaluation by the National Reference Center for Invasive Fungal Infections (NRZMyk), based in Jena. The yeast fungus, which was only discovered in 2009, can be transmitted between people and is immune to various medications.
“We are currently assuming with a high degree of certainty that this is a real increase in the number of cases and not a ‘better recording’,” said Oliver Kurzai from the Institute for Hygiene and Microbiology at the University of Würzburg, also head of NRZMyk, on Thursday . So far, the reference center is not aware of any deaths in Germany that can be directly attributed to an infection with the yeast fungus. Nevertheless, the fungus is dangerous, especially for people who are previously ill or have a weakened immune system.
According to Kurzai, in addition to bloodstream infections (“fungal sepsis”), infections of prostheses and foreign materials in the body caused by Candida auris are particularly threatening and difficult to treat, such as infections of joint prostheses.
What is Candida auris?
It is a pathogenic fungus that is one of the yeast fungi because of its special type of growth (“yeast-like”). It was first discovered in Japan in 2009. In the 70-year-old patient it was detected in the ear, hence the name (“auris”, Latin for ear). Samples examined subsequently indicate that a child in South Korea had already been infected in 1996. Candida auris is resistant to some antifungal medications, including some disinfectants. It is transmitted via smear infections and can sometimes remain on surfaces for months.
Researchers are pushing for a general reporting requirement
As early as 2023, Oliver Kurzai explained in an interview with t-online: “It’s quite worrying. The figures from the USA show the trend of a rapid increase in the number of confirmed cases of infection. We are observing the same trend in Europe, albeit at a much lower level so far Case numbers. But one must conclude: Candida auris is already endemic in parts of Europe. Overall, this means that the pathogen is continuing to spread worldwide.”
The research team led by Alexander M. Aldejohann from the University of Würzburg published the increase in the number of cases in Germany in the Epidemiological Bulletin of the Robert Koch Institute. Only some of these cases were recorded as part of the reporting requirement introduced in 2023, as this only applies to certain infections. A further increase in the number of cases in Germany must be assumed to be likely; a general reporting requirement for every laboratory finding could slow down the spread of the fungus. It also recommends comprehensive testing for Candida auris.
The fungus usually does not affect healthy people. It can become a problem in hospitals and care facilities, especially in intensive care units. Transmission occurs via smear infections. The pathogen, like the coronavirus, does not spread through the air. “If Candida auris gets into your bloodstream, there is a risk of blood poisoning, which is fatal in just over half of all cases,” write the researchers.
What are the effects of an infection?
Healthy people can be asymptomatically infected and are often unaware of their infection. The fungus can be dangerous for people with a weakened immune system, so it is particularly dangerous in hospitals or care facilities. Here it can be transmitted, for example, through medical instruments, catheters or breathing tubes, for example if the fungus is resistant to the disinfectants used. The WHO explains: “Candida auris is a globally widespread pathogenic yeast that causes invasive candidiasis (fungal infection – Editor’s note) in the blood, heart, central nervous system, eyes, bones and internal organs.
Among other things, infections of the urinary tract, wounds and blood poisoning occur. The mortality, i.e. the death rate, is quite high. If the fungus attacks the internal organs, it is between 29 and 53 percent – according to the WHO.
Outbreaks mainly in clinics
In 58 of 77 cases registered in Germany last year, the patients were infected with the fungus. According to the scientists, infection occurred in 13 other cases. In six cases the status is unclear. Of the colonized patients or those with unclear infection status, 5 would have developed an invasive infection later on. The most common infections were wound and tissue infections, bloodstream and catheter-associated infections and prosthetic infections.
It is said that the increase in Candida auris is primarily due to three outbreaks. “The enormous increase in 2023 surprised us. The decisive factor here is, above all, outbreaks in hospitals. If these are not recognized early and dealt with adequately, they will be very difficult to get under control later,” explained Aldejohann.
The yeast Candida auris, which was only discovered in 2009, has quickly spread internationally. From the beginning, the extremely stubborn pathogen was resistant to some antimycotics – drugs that combat fungal infections – and some disinfectants.