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THOMPSON: A mysterious and dangerous new fungus

April 29, 2019 - 12:00 PM

 


OPINION


The older you get the more you really understand that without good health…not much more matters. You understand that when you’re younger, of course, it’s just that most of us don’t have the sense of mortality at age 20 that we do at age 60. But regardless of age, when your good health turns to bad…it grabs your attention…it makes you focus on what’s critical in your life.

There are too many things that can kill you to worry about all of them all of the time…you’d spend most waking moments doing that rather than, well, living. That said, you need to be aware of what’s new that can jump up and grab you. Because, knowledge is power…and the old adage, an ounce of prevention is worth a pound of cure, happens to be right.

That’s why I’m writing about a mysterious and dangerous new fungus…Candida auris. A yeast…it’s mysterious because it’s showing up all over…South Africa, India, United States, England, Spain…and now, Canada. We don't really know why. It’s dangerous because once it gets in the bloodstream, it can cause serious disabilities and often kills…within 30 days. You see, C. Auris is resistant to most anti-fungal medicines…much like some bacteria are resistant to antibiotics.

C. auris isn’t easy to diagnose…fever and chills cover a wide range of illnesses. And…it’s not easy to cure. Some wag once said, “a hospital is no place to be sick.” That certainly is true when you consider that patients often have low resistance because of other illness or medical procedures…and the chances of infections from bacteria and fungi are pretty good.

But you don’t have to be in a hospital to get methicillin-resistant Staphylococcus aureus or MRSA and other bacterial infections, and the same can be said of fungal infections like C. auris. About one-third of infections occur outside hospitals. Generally, 20 percent to 30 percent of us have Staph bacteria on our hands or in our noses. We might not even be ill, but some of these bacteria are MRSA and we can spread it to others and they can become ill, according to Public Health Agency of Canada.

Staph - particularly MRSA - infected more than 119,000 people and killed nearly 20,000 people in the U.S. in 2017…the most recently reported year, according to the Centers for Disease Control. I could not find a verifiable number of deaths from MRSA here in Canada, but according to the Canadian Antimicrobial Resistance Surveillance System, “the overall rate of MRSA infection in sentinel hospitals in Canada increased from 2.84 cases to 3.13 cases per 10,000 patient-days from 2011 through 2016.”

Back to C. auris. As a yeast…C. auris grows rapidly. The fungus is the leading cause of bloodstream infections in North American hospitals. Most yeast infections don’t spread from person to person…but C. auris acts more like bacteria you might find in hospitals…sticking to surfaces easily and thus, easy to infect others.

C. auris is resistant to fluconazole, and increasingly resistant to amphotericin B, usually a last-resort treatment. Resistance can happen even as antibiotics and anti-fungals are administered to a patient…which further complicates treatment.

While over-prescribing antibiotics and anti-fungals  contributes to resistance issues…one of the main causes of the rise of these so-called “Super Bugs” - which seems more alarmist than necessary - is that patients don’t complete the prescribed antibiotics and anti-fungals. Too many people start feeling better and stop taking the medicine. Also, it appears that those who are most susceptible to C. auris are sick…really sick.

There are about 600 cases in 12 states in the U.S., according to the CDC. I could not determine how many cases are in Canada at this writing…but when I get word fromCanadian health officials, I’ll pass it on in a future column.

So, what to do besides be aware that health threats like C. auris exist? One thing we can all do is clean our hands…generally, and especially around people who are extremely ill at home, in hospitals, long-term care facilities and nursing homes. Those hand cleaning stations in our hospitals…we should use them without fail…before entering any hospital patient’s room. And if you see someone not doing that…speak up even if it’s a healthcare professional…most people aren’t going to be offended if you do it the right way.

Likewise, don’t be afraid to ask hospital officials whether C. auris is in the hospital, what is being done to eradicate it, whether patients are segregated and are items used in treatment - like blood pressure cuffs - disposable? Ask what kind of disinfectants the hospital uses…it should be the strongest available…effective against Clostridium difficile spores, which includes a host of pathogens that cause botulism, gas gangrene and tetanus, among others.

We should all know more about antibiotics and anti-fungals…ask our professionals to explain what we don’t know or understand. And if you have a loved one in a hospital intensive care unit, don’t be shy about asking healthcare professionals about the risk factors of intravenous antibiotics. Broad-spectrum antibiotics kill bacteria, including those healthy ones found in the gut…and might not be worth the risk.

We should rely on our healthcare professionals…my own personal experience is that Canadian physicians are less likely to prescribe antibiotics than those in the U.S. One thing is certain…all of us should have a good understanding of health issues and take an active role in staying healthy. And as far as C. auris? It probably shouldn’t be the last thing on our minds before sleeping tonight…but it is something worth knowing about.

— Don Thompson, an American awaiting Canadian citizenship, lives in Vernon and in Florida. In a career that spans more than 40 years, Don has been a working journalist, a speechwriter and the CEO of an advertising and public relations firm. A passionate and compassionate man, he loves the written word as much as fine dinners with great wines. His essays are a blend of news reporting and opinion.


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