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A deadly, drug-resistant mushroom has conquered the world – that's how it spreads



<img src = "https://cdn.arstechnica.net/wp-content/uploads/2019/06/GettyImages-984938380-800×534.jpg" alt = "The director of the German National Reference Center for invasive fungi infections with a Petri dish of yeast Candida auris in January 2018. "/>
Enlarge / The director of the German National Reference Center for Invasive Fungal Infections holds a yeast Petri dish Candida auris in January 2018.

Deadly infected patients Drug-resistant fungi drip with the dangerous germ who streams into their surroundings, where he waits for weeks in search of a new victim. This is clear from recent data released recently at the annual American Society for Microbiology annual meeting in San Francisco.

The data fill in critical unknowns about how the fungus Candida auris actually spreads. The germ is a relatively new threat, which experts classify as a new pathogen. He appears quickly and can lurk and kill in health care in an unusual way.

It was first identified in Japan in 2009. Since then, studies have tracked Globetrotter's fungus from South Korea in 1996 to an outbreak in New York health facilities, which began in 2013 and lasted until 2017. C. auris has appeared in more than 30 countries and usually leaves a body count everywhere.

The fungus is primarily involved in health care and steals into the blood of vulnerable patients, where it causes invasive infections characterized by inconspicuous fever and chills. It is generally resistant to several medications, and it has been found that some isolates resist all three classes of antimycotics, making healing extremely difficult, if not impossible. Experts estimate that C. auris infections have a mortality rate between 30% and 60%. It's hard to say, as many of the victims are seriously ill before becoming infected, making it difficult to pinpoint an individual cause.

Although the threat is clear, much is about C. Auris infections were cloudy – including the spread of one victim to another. Researchers have found that it lurks on hospital mattresses, furniture, sinks and medical equipment, but they have not realized how it got there. But once it's there, it's hard to destroy it. The fungal cells can form solid, tenacious clots that can live on plastic for at least two weeks and enter a metabolically quiescent phase for one month.

Torrential Terror

For the new study, researchers from the Centers for Disease Control and Prevention and the City of Chicago's Public Health Department have been trying to pinpoint how it gets to these surfaces. They hope that this can lead to a way to prevent its dissemination. They performed their work in a ventilator-care facility that is currently fighting an outbreak that started with an isolated case in March 2017. Despite rigorous decontamination efforts, including bleaching surfaces and wiping patients, 71 percent of residents have now performed positive tests on the fungus.

The researchers hypothesized that the fungus spreads by shedding itself from the skin of infected patients. Although the C. Auris usually occurs in a bloodstream infection, researchers have found it on the skin of healthy people. And such a skin detachment would be a relatively simple explanation for the dispersion in health care facilities.

The researchers wiped the skin of 28 residents and their rooms and fished for living fungal cells and the genetic fingerprints of the strain. They found much of both. The skin of the inhabitants was loaded with the fungus, with some skin smear concentrations corresponding to more than 10 million fungal cells per milliliter. The researchers found that the extent of fungal contamination in each resident's room correlated strongly and positively with the degree that festered on the resident's skin. That is, the more fungus, the more space pollution.

The finding supports the hypothesis that skin detachment is the primary agent with which C. auris comes around. The researchers are confident that the data linkage can contribute to better decontamination and infection control.

As of April 30, the CDC reported 654 confirmed cases in a dozen states by 2019, with another 30 likely cases. Screening in nine states identified another 1,207 patients who carried the fungus without infection.


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