New Delhi: Since a global
alert on pathogenic fungus Candida auris in 2009, Indian scientists have been
actively engaged in research on the strains of this fungi. A recent report of
the study indicates that the strains found in Indian hospitals are multi-drug
resistant.
The Council of Scientific and Industrial Research–Institute of
Genomics and Integrative Biology (CSIR-IGIB), New Delhi, and Department of
Medical Mycology, Vallabhbhai Patel Chest Institute, Delhi University,
conducted a full genome sequencing on six strains of Candida auris, and have
published their findings in the latest issue of the UK journal Elsevier.
“A full genome sequencing analysis of Candida Auris isolates
from four Indian hospitals - three in Delhi and one in Kochi - revealed a
clonal transmission, that is the same strains were circulating in Indian
hospitals. All C. auris isolates analysed originated from cases of fungaemia
(fatal fungal infection, a form of sepsis) and were resistant to fluconazole (a
broad-spectrum antifungal medication),” said Dr Anuradha Choudhary, Associate
Professor and Head, Department of Medical Mycology, Vallabhbhai Patel Chest
Institute.
“This emerging multi-drug resistant yeast causes acute
hospital-acquired infections. The emergence of this yeast is alarming doctors,
as it also exhibits resistance to azoles, amphotericin B and caspofungin, all
anti-fungal drugs,” she said.
Molecular identification are not part of routine testing in
diagnostic laboratories, and C. auris can only be identified by genome
sequencing. Doctors insist that due to this, fungaemia is likely to be much
more prevalent than reports indicate. As per IGIB and Delhi's Chest Institute
reports, about 40 cases have been documents until 2015.
C. auris infection has been reported to occur in all age groups,
and bloodstream infections have a 60 per cent mortality rate.
Hospitalised patients are at high risk. “Recent surgery,
diabetes, broad-spectrum antibiotic and anti-fungal drugs, and central venous
catheter use are all risk factors,” said Dr Anoop Misra, Chairman,
Fortis-C-DOC, Centre for Diabetes, Metabolic Diseases and Endocrinology.
“Fungus infections, especially multiple drug-resistant ones, are
difficult to treat and C. auris in particular carries a high mortality rate.
With prevalence of suppressed immune response among patients, including those
with uncontrolled diabetes, this is a big concern. Early diagnosis and
treatment is crucial,” said Dr Misra.
As part of standard procedure, ICMR is already looking into
this. Director General, ICMR and Secretary, Department of Health Research,
Ministry of Health and Family Welfare, Dr Soumya Swaminathan, said, “We have a
network of tertiary hospitals looking at fungal infections and their drug resistance.
We are also looking at how common Candida auris is.” Frequent use of
antibiotics or anti-fungals is supposed to be a cause of origin for any
multi-drug resistant fungi. Doctors have urged for the need for new
antibiotics.
At least a dozen countries have reported drug-resistant Candida
Auris, in the last five years. C. auris was first reported in 2009 after being
isolated from the external ear canal discharge of a patient in Japan. In the
same year, about 15 isolates of C. auris were reported in South Korea.
Source: DNA-15th-December-2016
