Outbreaks of Untreatable, Drug-Resistant Fungus Spread in 2 Cities

While C. auris has long been notoriously hard to treat, researchers for the first time identified five patients in Texas and Washington, D.C., whose infections did not respond to any of the three major classes of antifungal medication. So-called panresistance had been previously reported in three patients in New York who were being treated for C. auris, but health officials said the newly reported panresistant infections occurred in patients who had never received antifungal drugs, said Dr. Meghan Lyman, a medical officer at the C.D.C. who specializes in fungal diseases.

“The concerning thing is that the patients at risk are no longer the small population of people who have infections and are already being treated with these medications,” she said.

Infectious disease specialists say the coronavirus pandemic has probably accelerated the spread of the fungus. The shortages of personal protective equipment that hobbled health care workers during the early months of the pandemic, they say, increased opportunities for the fungus’s transmission, especially among the thousands of Covid-19 patients who ended up on invasive mechanical ventilation.

The chaos of recent months also did not help. “Infection control efforts at most heath care systems are stretched thin in the best of times, but with so many Covid patients, resources that might have gone to infection control were diverted elsewhere,” Dr. Clancy said.

For many health experts, the emergence of a panresistant C. auris is a sobering reminder about the threats posed by antimicrobial resistance, from superbugs like MRSA to antibiotic-resistant salmonella. Such infections sicken 2.8 million Americans a year and kill 35,000, according to the C.D.C.

Dr. Michael S. Phillips, chief epidemiologist at NYU/Langone Health, said health systems across the country were struggling to contain the spread of such pathogens. The problem, he said, was especially acute in big cities like New York, where seriously ill patients shuttle between nursing homes with lax infection control and top-notch medical centers that often draw patients from across a wider region.

“We need to do a better job at surveillance and infection control, especially in places where we put patients in group settings,” he said. “Candida auris is something we should be concerned about, but we can’t lose sight of the bigger picture because there are a lot of other drug-resistant bugs out there we should be worried about.”