Candida auris: fungal foes

When you are sick with an infection caused by bacteria, like strep throat, your doctor may prescribe antibiotics to help you feel better. For viral infections, like the flu, antiviral medications can also be helpful. These kinds of medications are called antimicrobials, because they help people recover from infection-causing microbes.

But, did you know there is another kind of microbe that can cause illnesses? Fungi like molds and yeasts can cause a wide range of infections, from athlete’s foot to serious bloodstream infections. Most of these fungal infections can be treated with antifungals, but just like some bacteria, it seems some fungi are growing resistant to the medicines meant to kill them.

Resistance to Antimicrobials

At a specialized research lab at the National Microbiology Laboratory (NML) in Winnipeg, Public Health Agency of Canada (PHAC) scientists are studying a very tricky fungus called Candida auris (C. auris). Unlike most other fungi in the Candida family, C. auris can be multidrug resistant, which means it can be unaffected by at least two types of antifungals. This is a big concern because, for now, there are only three types of antifungal medications in use.

C. auris can be difficult to identify and it requires specialized testing to confirm its presence. It is most harmful to people with already-compromised immune systems, such as patients undergoing treatment for cancer or blood disorders. On top of this, C. auris tends to survive in hospital environments, which puts the most at-risk people in higher danger of contracting it.

C. auris in Canada

Since 2012, there have been 21 known cases of C. auris in Canada. Many of these cases, however, were travel-related and did not originate within the country. While Canada has had very few cases of C. auris when compared to other countries, reports of the fungus have been increasing significantly around the world over the last five years. Dr. Amrita Bharat is a scientist at the NML researching the tricky fungus. “At this moment, Canadian hospitals seem to be protected, so it is imperative to continue developing methods of finding and treating Candida auris before more cases appear,” says Dr. Bharat.

To improve diagnosis of C. auris infections, researchers at the NML are working with Canadian hospitals on methods to accurately and quickly identify the fungus.

“We want to give healthcare professionals the tools to diagnose infections on-site and minimize the potential for infection among at-risk patients,” said Dr. Bharat. “The goal is to help the country be better prepared for an outbreak, if one occurs.”

PHAC leads two networks that facilitate communication about C. auris among federal, provincial and territorial labs, as well as healthcare facilities. The Canadian Nosocomial Infection Surveillance Program (CNISP) monitors healthcare-related illnesses, offering hospitals the opportunity to connect with each other. The Canadian Public Health Laboratory Network (CPHLN) provides the same opportunity to federal, provincial and territorial laboratories.

With these two programs, PHAC is facilitating conversations that help prepare for C. auris so that scientists can better find the source and prevent further spread of any new cases. PHAC’s proactive approach is essential to keeping Canadians protected from this emerging pathogen.

“The best way to prevent Candida auris infections is to be aware and be prepared,” says Dr. Bharat. “For healthcare providers, this means having a plan in place. For patients, this means thorough handwashing and letting your doctor know if you have been hospitalized outside of the country.”