4/12/2019 City hospitals sound alarm over drug-resistant fungus - The Times Of India - Kolkata, 4/12/2019

City hospitals sound alarm over drug-resistant fungus

Prithvijit.Mitra@timesgroup.com

Kolkata:

Some Kolkata hospitals have sounded the alert about a deadly fungus that’s on the prowl across India and neighbouring
countries, apart from North America, Europe and Australia. Candida auris (C auris) is multidrug resistant, strikes those with low
immunity and has a mortality rate of up to 72%. Doctors in Kolkata say they have encountered the fungus, which has triggered
deaths.

Infections are rare, but an outbreak could be very difficult to contain, as few hospitals in the city can detect it. Doctors suspect
there are already a large number of undetected cases in the country.

At least two private hospitals in the city have alerted their consultants about the threat and asked them to identify suspected
patients.

Even though not as common as Candida albicans — a pathogenic yeast that has been invading Kolkata hospitals in recent years
— C auris has been striking intermittently. “Fungal infections are detected late, which delays treatment,” said Apollo Gleneagles
Hospital consultant Shyamasis Bandopadhyay. “C auris is deadly, since it is multi-drug resistant. Over the last six-seven years, I
have come across several C auris patients, of whom around half didn’t survive.”

‘Rampant, non-judicious use of high-end antibiotics is a risk’

The fungus triggers fever, which refuses to go for weeks, low blood
pressure, a rapid pulse, respiratory distress and low urine formation.
In such cases, the protocol is to use antibiotics and wait for 48
hours. “If the fever doesn’t go, a blood sample has to be sent for
fungal culture to detect infection. Once detected, anti-fungal drugs
need to be administered intravenously. Even if no fungus is
detected, it is safe to use the anti-fungal drugs empirically,” said
AMRI Hospital consultant Debashish Saha, adding that Candida
albicans was more common in Kolkata. “Both are fungi but C auris
is resistant to common drugs.”

C auris grows in the bloodstream or internal organs and multiplies exponentially, especially in patients with low immunity.
“Diabetics, those with kidney, lung, cardiac ailments and cancer patients are vulnerable, along with children and the elderly. The
first symptom is fever and it’s usually followed by breathing distress, pneumonia, heart or brain ailments and sepsis,” said
consultant Arindam Biswas.

Both C auris and C albicans are often found in body cavities like the mouth, nose and vagina. “Generally, they remain harmless
till the carrier starts suffering from low immunity. Once C auris multiplies and infiltrates the bloodstream, it’s risky,” said Saha.

Patients invariably catch the germ in hospitals. According to a private hospital consultant, the fungus was endemic in some
hospitals and a spread is a constant threat.

C auris rarely spreads from the community, according to Medica Superspecialty Hospital microbiologist Aviral Ray. “Rampant
and non-judicious use of high-end antibiotics is a risk. Once an individual gets resistant to antibiotics, he or she is likely to
remain in hospital for a longer period, leading to a higher chance of contracting the fungus. The fact that C auris is drug-resistant
makes it more dangerous,” said Ray. He added that laboratory equipment needed to identify the fungus were hardly available in
India. “We probably have a large number of undetected cases and the threat is bigger than what we perceive it to be.”

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