There’s a new superbug, or drug-resistant germ, that Massachusetts healthcare facilities are dealing with, and it presents a serious global health threat.
In 2017, a 71-year-old man with end-stage lung disease, who was admitted to Massachusetts General Hospital, died from the pathogen called Candida auris, a yeast-like fungus, according to a report from Massachusetts General Hospital.
Candida auris, or C. auris, can cause serious bloodstream infections and even death, especially among hospital and nursing home patients who have compromised immune systems. More than one in three patients with an invasive Candida auris infection dies, according to the Centers for Disease Control and Prevention.
And because it's a pathogen that's becoming more common, Dr. Michael Mansour, an infectious disease researcher at MGH, said there's cause for concern with Candida auris, since it’s highly drug resistant.
“This is the first time we've had a fungal representative in the superbug family,” Mansour said. “And it certainly has full membership rights. It is resistant to almost all classes of antifungals.”
Candida is typically found on our skin, in our mouth and in our gut. Normally, it's not a problem. But this specific species popped up in Japan in a women's ear in 2009. The fungus quickly spread to other countries. It arrived in the United States in 2013.
The most common symptoms are high fever and chills. It can be difficult to diagnose, especially when people already are sick.
“What’s problematic about Candida auris is, first of all, how difficult it is to treat,” said Dr. Lawrence Madoff, medical director of the Bureau of Infectious Disease at Massachusetts Department of Public Health. “It can cause serious invasive infections — for example, bloodstream infections — and itpropensity to spread and cause outbreaks in health care settings.”
Hundreds of C. auris cases are confirmed in New York, New Jersey and the Chicago area, according to the CDC. In 2017, Massachusetts had seven known cases, but none in 2018.
Madoff said strict containment and prevention measures are in place in all healthcare facilities in Massachusetts, and the CDC has a reporting protocol — all an attempt to track and keep down infection rates.
“I think it's definitely an organism that is more likely to cause infection or problems with individuals who are more medically fragile," said Melissa Cummings, an epidemiologist with the Massachusetts Department of Public Health. Cumming said that for the average healthy person, there’s not much to worry about. But if you're sick, you're vulnerable.
The CDC reports more than 600 confirmed cases nationwide.
But the government and healthcare officials have been somewhat reluctant to talk about it since C. auris first appeared in the United States seven years ago. And that secrecy continues.
The Mass Department of Public Health wouldn't tell WGBH News which hospitals or healthcare facilities have experienced cases of Candida auris. MGH officials said their only patient died from it.
At Mansour's lab at MGH, research continues to look for ways to fight off C. Auris. But doctors say in order to curtail the spread of Candida auris and other superbugs, the best short-term solution is better antibiotic and anti fungal medicine, as well as preventing the overuse of these drugs in the first place.
Because it's so new and arrived on the scene so quickly, Mansour said researchers are still learning about Candida auris -- and there's a lot to figure out.
“It is a mystery ... with regard to how it came about. Where's it going? How do we truly stop and halt this progression?“ Mansour said.
This article has been updated to correct the spelling of Dr. Michael Mansour's last name. It is Mansour, not Monsour.
