In recent years, hospitals nationwide have been reporting an increase in life-threatening illnesses resulting from a deadly fungal infection caused by the yeast Candida auris that can enter the bloodstream. This yeast is difficult to identify and often does not respond to commonly used antifungal drugs, leading to high mortality.
Infections have been observed in 10 states, with most cases in the New York City metropolitan area and in New Jersey. It is prevalent in patients who have been hospitalized a long time, have lines or tubes entering their body, or have previously received antibiotics or antifungal medications.
Recognizing this emerging fungus as a global health threat, the Centers for Disease Control and Prevention has awarded Rutgers University a $300,000 contract over two years to address this deadly pathogen as part of the CDC's Antibiotic Resistance Solutions Initiative.
The Rutgers team – led by David Perlin, executive director and professor of the Public Health Research Institute at Rutgers New Jersey Medical School, and postdoctoral fellow Milena Kordalewska – will identify a new way to rapidly and accurately detect C. auris in swabs from patients and hospital environments. They will also analyze transmission patterns in New Jersey healthcare facilities using genetic fingerprint technology, in collaboration with Thomas Kirn, medical director of the Public Health Laboratory Service at the New Jersey Department of Health, associate professor of pathology and laboratory medicine at Rutgers Robert Wood Johnson Medical School and director of clinical microbiology and infectious disease diagnostics at Robert Wood Johnson University Hospital.
"What makes C. auris so alarming is that it is largely a drug-resistant, healthcare-associated infectious agent that can be easily transmitted between patients and the patients' environment," says Perlin. "This is extremely rare for a yeast."
In 2009, C. auris was first described in a patient in Japan. As of September 18, 2017, the CDC reported 153 confirmed and probable infections due to the yeast in the nation. There is documented transmission of C. auris to U.S. patients from healthcare facilities in India, Pakistan, South Africa and Venezuela.
"As reports of C. auris continue to mount within U.S. healthcare facilities, it is worrisome that the problem may grow much worse," says Perlin. "The keys to containing the epidemic are infection control, the development of molecular tools to reliably and rapidly identify the pathogen and a better understanding of its genetic profile that facilitates transmission within hospital environments."
Fungal infections often cause serious disease among patients with compromised immune systems or other debilitating conditions resulting in high morbidity and mortality. Globally, nearly 1.4 million deaths a year are attributed to invasive fungal infections, which is on par with deadly diseases like tuberculosis.