How to prevent and treat Candida auris infection
2023-11-08
Candida auris can either cause symptoms of infection in humans or simply live in humans. If the fungus enters the bloodstream, it can cause a serious invasive infection, during which patients experience typical symptoms of infection, such as fever. Candida auris can also live in specific areas of a person's skin, rectum, vagina or mouth, but carriers do not show symptoms of infection, a condition known as "asymptomatic colonization". Candida auris can infect other people through "asymptomatic carriers".
Candida auris can be transmitted through direct or indirect contact, such as through skin and clothing. Candida auris can live in the environment for several weeks and can cause "explosive" transmission in healthcare settings. If the diagnosis is inaccurate and the treatment is not timely, the patient will become more sick and at risk of death.
Megan Lehmann, a CDC expert, said that it is not clear how many deaths in the United States can be directly attributed to Candida auris because these infected people often have a variety of other health problems or diseases, and Candida auris may be the direct cause of death, or it may be a combination of other adverse health factors that hasten the death of patients.
Although most Candida auris infections can be treated with specific antifungal drugs, drug resistance to C. auris may be an important factor in death in infected individuals. Current clinical and laboratory studies have found that Candida auris is multidrug-resistant. CDC data shows that 90% of infected people are resistant to at least one antifungal drug, while 30% of infected people are resistant to at least two drugs.
Currently, most strains of Candida auris are resistant to fluconazole, and resistance varies between strains. In the United States, about 90% of Candida auris strains are resistant to fluconazole, 30% are resistant to amphotericin B, and 5% are resistant to echinocandin. Therefore, high-dose multifungal combination therapy can be used in cases of multidrug resistance.
According to the genetic sequencing of the earliest isolated Candida auris in China, it is closely related to isolates from India, Pakistan and France, but it is different from the multidrug-resistant phenotype of Candida auris found in many countries. The Chinese Candida auris isolates are sensitive to the commonly used antifungal drugs fluconazole, itraconazole, posaconazole, voriconazole, amphotericin B, 5-fluorocytosine, anidulafungin, caspofungin and micafungin, indicating that these drugs have efficacy against Candida auris in China. In addition, Chinese researchers have also found that copper sulfate has a strong growth-inhibiting effect on Candida auris
Further research by Chinese researchers also found that Candida auris can grow in both high temperature and high salt environments, and has a variety of cell morphologies, such as spherical, oval, and elongated, in different growth environments. At 25°C, 37°C, 40°C, and even 42°C, Candida auris can still secrete a large amount of the virulence factor aspartyl protease (Saps), which is an important virulence factor for Candida auris to cause host tissue damage.
These results provide new ideas and methods for the clinical prevention and treatment of Candida auris infection. To prevent Candida auris infection, copper sulfate can be disinfected in the hospital to remove the fungus that has colonized the hospital. Infected patients can be treated with a combination of antifungal drugs, such as fluconazole, itraconazole, amphotericin B, and 5-fluorocytosine. In daily life, good personal hygiene should be maintained, hands should be washed frequently, and indoor and home hygiene should be maintained to prevent Candida auris infection.
