Move over bedbugs and cockroaches—New York City is now grappling with the formidable challenge of “superbugs” that are proving hard to eliminate.
One such pathogen is Candida auris, a resilient fungus that can endure on surfaces even after cleaning, often resists standard antifungal treatments, and poses a severe threat by causing potentially deadly bloodstream infections.
Since its official identification in New York in 2016, the state has witnessed a continual rise in Candida auris cases. Last year, there were 623 clinical cases, where individuals fell ill due to the fungus, and 849 surveillance cases, where people tested positive but did not exhibit symptoms.
Research conducted last year revealed that the New York City/New Jersey metropolitan area constitutes nearly 20% of Candida auris cases in the United States. Experts attribute this increase to heavy travel and trade with South Asia, suggesting it as the origin of the outbreak.
Candida auris is not alone in its assault on New York City. Medical authorities caution that the excessive use of antibiotics is contributing to a rise in “nightmare bacteria,” which have developed resistance to most available medications.
“When someone has a viral illness, like a respiratory cold, antibiotics offer zero benefit but carry potential risks, including side effects and allergic reactions. More importantly, they contribute to the development of drug resistance,” explained Dr. Aaron Glatt, professor and chair of the Department of Medicine at Mount Sinai South Nassau, in a conversation with The Post.
“The entire opportunity here is for people to use the antibiotics appropriately.”
Antibiotics should be used to treat or prevent bacterial infections such as strep throat, urinary tract infections and bacterial pneumonia.
They shouldn’t be used to address viral infections like colds, flu, COVID-19 or most sore throats because they are ineffective against these ailments and contribute to antibiotic resistance.
Bacteria primarily develop antibiotic resistance through natural genetic mutations. These resistant strains then spread their genetic material to other bacteria.
Last fall, the World Health Organization noted that 1 in 6 bacterial infections were resistant to common antibiotic treatments. In fact, the agency reported that antibiotic resistance rose by an average of 5% to 15% annually between 2018 and 2023.
This problem snowballed during the COVID-19 pandemic because many patients with mild to moderate cases of the coronavirus unnecessarily received antibiotics.
“It’s a combination of patients requesting … antibiotics when they don’t need them,” Glatt said. “It’s also incumbent upon physicians to say, ‘No, this disease is not treated with an antibiotic.’”
There is some reassuring news â though Candida auris has become more prevalent in New York, the fungus primarily spreads within healthcare facilities like nursing homes and hospitals.
“It is not something that is of great concern to the typical person on the street,” Glatt said, “but it is especially concerning for patients from nursing homes and … patients who receive multiple antibiotics and are very sick themselves and they’re immunocompromised.”
Encouragingly, new drugs have shown effectiveness against certain types of resistant bacteria, such as E. coli and Klebsiella pneumoniae.
Federal bipartisan legislation â first proposed in 2020 and reintroduced last month â aims to replenish the antibiotic pipeline to continue the battle against nightmare bacteria.
The Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act would ensure payments to pharmaceutical companies based on the value and innovation of their new antibiotics instead of the number of drugs they sell.
This Netflix-like “subscription” model is designed to stabilize the market and encourage research.
“This Netflix model says the government will pay the pharmaceutical [companies] a flat fee for the access to these antibiotics, no matter how much is used or not,” Glatt explained.
“This way, the pharmaceutical industry would be adequately reimbursed with [research and development] that they do,” he continued, “and at the same time, if the drug gets used a lot, it won’t be as expensive.”
