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Deadly Drug-Resistant Fungus Is 'Quietly Spreading Across the Globe' (msn.com)
A drug-resistant fungus called Candida auris "is quietly spreading across the globe," reports the New York Times:
Over the last five years, it has hit a neonatal unit in Venezuela, swept through a hospital in Spain, forced a prestigious British medical center to shut down its intensive care unit, and taken root in India, Pakistan and South Africa. Recently C. auris reached New York, New Jersey and Illinois, leading the federal Centers for Disease Control and Prevention (CDC) to add it to a list of germs deemed "urgent threats...."
In the United States, two million people contract resistant infections annually, and 23,000 die from them, according to the official CDC estimate. That number was based on 2010 figures; more recent estimates from researchers at Washington University School of Medicine put the death toll at 162,000. Worldwide fatalities from resistant infections are estimated at 700,000.... With bacteria and fungi alike, hospitals and local governments are reluctant to disclose outbreaks for fear of being seen as infection hubs.
Even the CDC, under its agreement with states, is not allowed to make public the location or name of hospitals involved in outbreaks. State governments have in many cases declined to publicly share information beyond acknowledging that they have had cases.... [A] hushed panic is playing out in hospitals around the world. Individual institutions and national, state and local governments have been reluctant to publicize outbreaks of resistant infections, arguing there is no point in scaring patients -- or prospective ones.
The Times reports that C. auris targets people with weakened immune systems (including babies and the elderly) -- and that 587 cases of C. auris have already been reported in the U.S., according to the CDC: 309 cases in New York, 104 in New Jersey, and 144 in Illinois. The CDC adds that half the patients who contract C. auris die within 90 days.
It also survived in a room treated for an entire week with aerosolized hydrogen peroxide, according to the Times. "Simply put, fungi, just like bacteria, are evolving defenses to survive modern medicines."
The New York Post adds that "Given the speed at which the inspection spreads, coupled with its resistance to medication, 'the prospect of an endemic or epidemic multidrug-resistant yeast in U.S. healthcare facilities is troubling,' the CDC said in October."
In the United States, two million people contract resistant infections annually, and 23,000 die from them, according to the official CDC estimate. That number was based on 2010 figures; more recent estimates from researchers at Washington University School of Medicine put the death toll at 162,000. Worldwide fatalities from resistant infections are estimated at 700,000.... With bacteria and fungi alike, hospitals and local governments are reluctant to disclose outbreaks for fear of being seen as infection hubs.
Even the CDC, under its agreement with states, is not allowed to make public the location or name of hospitals involved in outbreaks. State governments have in many cases declined to publicly share information beyond acknowledging that they have had cases.... [A] hushed panic is playing out in hospitals around the world. Individual institutions and national, state and local governments have been reluctant to publicize outbreaks of resistant infections, arguing there is no point in scaring patients -- or prospective ones.
The Times reports that C. auris targets people with weakened immune systems (including babies and the elderly) -- and that 587 cases of C. auris have already been reported in the U.S., according to the CDC: 309 cases in New York, 104 in New Jersey, and 144 in Illinois. The CDC adds that half the patients who contract C. auris die within 90 days.
It also survived in a room treated for an entire week with aerosolized hydrogen peroxide, according to the Times. "Simply put, fungi, just like bacteria, are evolving defenses to survive modern medicines."
The New York Post adds that "Given the speed at which the inspection spreads, coupled with its resistance to medication, 'the prospect of an endemic or epidemic multidrug-resistant yeast in U.S. healthcare facilities is troubling,' the CDC said in October."
Of course there is evolution in pathogens. The common cold and influenza are good examples here. Luckily for us humans, both of these are benign in most cases where humans have a working immune system and take some time to rest.
The main difference between our immune system and these antimicrobials is that antimicrobials can not adapt.
These are basically inanimate poisons for the pathogens, which destroy their cell membranes and or otherwise inhibit their ability to reproduce.
Our immune system however is capable of 'learning', it can adapt to new circumstances.
The problematic pathogens we are talking about here are microorganisms that generally can exist outside of a host. Microorganisms whose metabolisms are pretty flexible and they can get their energy (food) from various sources.
Now these kinds of bugs, which can replicate as long as there's food (and water) and some places that weren't sterilized thoroughly enough, are always exposed to the same kind of antagonist.
And due to their short replication cycles the likelihood of developing a resistance against that particular antagonist is increased.
This makes the overuse of these antimicrobials concerning, while disinfecting hospital equipment or hospital space in general, when doctors prescribe unnecessary antibiotics for things like inflamed throats because colds or flus (which are caused by viruses), when livestock is unnecessarily fed antibiotics and so forth.
When it comes vaccines you can think of it this way: Pathogens will enter in the human body no matter what.
Strengthening the hosts natural immune responses does reduce the time frame in which they can mutate inside a host.
It also reduces the time frame during which the host may infect other hosts.
Hypothetically a super bug could emerge here as well, we should not deny this possibility. For example if a host was constantly exposed to a significant enough external supply of these pathogens, this may be a plausible scenario.
The big question would be if we're artificially speeding up that evolution with vaccination like with the overuse of antimicrobials or not.
Fortunately empirical evidence with cases like polio or small pox support the assumption that pathogens don't fare as well against a vaccinated adaptive immune system than against these 'static' antimicrobials.