Rise of super fungus also “inevitable” in Belgium

Candida auris was only identified in humans for the first time in 2009, in the ear of a woman in Japan. Hence the name ‘auris’, Latin for ear. Since then, the fungus has been on an unstoppable rise. There have already been outbreaks in hospitals in the US, Mexico and India and closer to us in the UK, Spain and Italy.

Countries that have so far been spared are also increasingly confronted with the fungus. Germany reported 77 cases last year, six times more than in previous years. The Flemish Healthcare Department warned hospitals in April last year to be vigilant. With good reason, as it now appears. “We had 6 reports in 2023, possibly 7. One hospital sent an incorrect strain. These are clearly more reports than in previous years,” says Professor Katrien Lagrou, who heads the national reference laboratory for fungal infections at UZ Leuven.

Patient in isolation

The number of cases remains limited, but the upward trend is there. And while for a long time it only concerned imported infections, no link with a foreign hospital stay was found in three more recent cases. “Then you know it is here and will emerge more and more,” says Lagrou.

According to her, the further advance of Candida auris is inevitable. The Department of Care also realizes this. The fungus will soon become reportable, so that hospitals can be actively helped to prevent further spread. The Superior Health Council is now finalizing advice, Lagrou knows. “A patient must immediately go into isolation. The rest of the department is screened. In the worst case, an entire department has to be closed.”

Draconian, but it is often the only way to avoid a larger outbreak. Candida auris is also called a super fungus. It spreads easily, is resistant to most medications and if it enters the bloodstream it is extremely deadly.

1 in 3 dies

The fungus mainly spreads in hospitals and is difficult to slow down because it can survive in that environment, such as on bedding and door handles. A hospital in Brooklyn even had to tear out the ceiling to get rid of the mold. Isolating patients and consistently disinfecting the room is a cumbersome, but crucial task. In addition, those who have been infected or colonized rarely realize this. “The fungus becomes part of your skin flora and is mainly found on the groin and armpits. This way you can carry it with you for a year or longer without feeling or seeing it,” says Lagrou.

In the event of an infection in which Candida auris enters the bloodstream, it becomes fatal. About one in three dies. Patients with a weakened immune system are particularly at high risk and there are few treatment options. The fungus quickly becomes resistant to available medications. Compared to viruses and bacteria, little research is conducted on fungi. “There are now a number of antifungals in the pipeline, but it may be a matter of years before they can serve as a therapy,” says Lagrou. “Until then, it is important to introduce a reporting obligation. So that we can get a good idea of ​​the number of cases and verify that hospitals are taking the right measures.”