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In a concerning development, scientists have identified a global rise in a drug-resistant fungus that poses significant treatment challenges. Known as Candida auris, this invasive yeast predominantly affects individuals with compromised immune systems and has now been reported in over 60 countries, including the United Kingdom.
Fungal infections impact approximately 6.5 million people annually, with mortality rates exceeding 50% even when antifungal medications are administered. Experts are particularly worried about C. auris due to its rapid spread in healthcare environments, its resistance to several antifungal drugs, and its increasing virulence.
A recent review published in Nature Microbiology sheds light on the fungus’s ability to proliferate. It can transform from a yeast-like form into structures that enhance its capacity to invade and resist drugs. Moreover, specialized proteins enable it to adhere to human skin.
The researchers emphasized the medical risks, noting, “Colonization of the skin by C. auris is a significant concern, as affected patients can facilitate the transmission of the fungus within and between hospitals,” according to the Manchester Evening News.
Due to its ability to persist on surfaces and medical devices, outbreaks are often linked to equipment like catheters, feeding tubes, and ventilators. The fungus is present on the skin and in bodily fluids, leading to severe infections in the bloodstream, wounds, and ears. Alarmingly, some individuals may carry the fungus without exhibiting any symptoms.
The study also highlighted that the diagnosis of C. auris is frequently “hampered by misidentification,” which can delay the initiation of effective treatment.
“Taken together, these data underscore the need to develop novel antifungal agents with broad-spectrum activity against human fungal pathogens, to improve diagnostic tests, and to develop immune- and vaccine-based adjunct modalities for the treatment of high-risk patients.”
Symptoms often resemble bacterial infections, including fever and chills, but vary depending on where the infection develops. Outside the UK, severe invasive infections are associated with ‘high mortality’, the UKHSA warned.
In England, confirmed cases remain relatively rare but are on the rise. UK Health Security Agency (UKHSA) data showed 637 cases were reported between January 2013 and December 2024, with just 26 cases in 2021, 38 in 2022, 93 in 2023, and rising to 178 in 2024.
Dr Rohini Manuel, consultant microbiologist at UKHSA, said earlier this year: “Rates of C auris in hospitals in England are very low, however they have been rising in recent years. The data covers infections and colonisations, which means that the fungus is present on the skin but is not causing illness.
“UKHSA is working with the NHS to investigate the reasons behind the increase, although factors may include a rise in the fungus globally. Hospital outbreaks in this country are rare but we are supporting a small number of Trusts in managing ongoing outbreaks of colonised patients, coordinating infection prevention and control efforts, and maintaining patient safety.”
The fungus was first discovered in 2009 in the ear canal of a patient in Japan and soon spread to many countries, including India, where it was identified as a major public health threat in 2014.
“C. auris, previously rarely detected in England, has been emerging over the last decade, particularly following the lifting of travel restrictions imposed during the COVID-19 pandemic period,” the UKHSA said.
The World Health Organisation (WHO) classified C. auris as a ‘critical priority’ pathogen in 2022 due to its rapid spread and increasing resistance to existing treatments.