LISTEN: Emory University School of Medicine is looking at a new way to treat multi-drug-resistant infections. This comes as the Centers for Disease Control and Prevention issues a public health warning on Candida auris. GPB’s Ellen Eldridge reports.

A strain of Candida auris cultured in a petri dish.

This undated photo made available by the Centers for Disease Control and Prevention shows a strain of Candida auris cultured in a petri dish at a CDC laboratory. In a CDC paper published by the Annals of Internal Medicine on Monday, March 20, 2023, U.S. cases of the dangerous fungus tripled over just three years, and more than half of states have now reported it.

Credit: Shawn Lockhart/Centers for Disease Control and Prevention via AP, File

An emerging drug-resistant fungus is threatening health care facilities across the country, according to the Centers of Disease Control and Prevention.  

Candida auris spread at an alarming rate in 2020 and 2021, and the CDC considers the fungus an urgent threat because it is often resistant to multiple antifungal drugs, spreads easily in health care facilities, and can cause severe infections with high death rates. 

The relatively new fungus is front and center, and of concern to public health right now, an infectious disease expert with Emory University School of Medicine said.  

Dr. Michael Woodworth, an assistant professor of infectious diseases at Emory, said the first reason is that C. auris is known to cause serious infections, particularly bloodstream infections, and mortality.

This fungal infection is chiefly seen among people who already are sick or have weakened immune systems, Woodworth said.

"And it's notable that more than one in three patients who have invasive Candida auris may ultimately die from that infection,” he said. 

Another reason C. auris is a priority pathogen is because its resistance to medications is unprecedented compared to other similar yeasts, Woodworth said.

“The antifungals that are most commonly used to treat Candida often don't work for Candida auris,” he said. “And this, of course, makes them more difficult to treat.”

Woodworth thinks there is an ongoing need for greater attention to antimicrobial resistance among yeasts such as C. auris, and bacteria.

His work in the past several years focused on understanding the role of the gut microbiome as a way to protect from colonization of pathogens.

What we eat affects our resistance to infection.

The intestinal tract contains millions of microorganisms, often referred to as the “gut flora," or "gut microbiome."

Certain situations, such as taking antibiotics to treat an infection, may change the balance of microorganisms in the gut, which could allow bacteria to multiply and release toxins causing diarrhea, abdominal pain and fever, and in some cases, organ failure and death.

Woodworth’s team successfully treated 8 out of 10 kidney transplant recipients with drug-resistant infections in a small clinical trial, using a novel intervention called fecal microbiota transplant

The administration of fecal microbiota is thought to facilitate restoration of the gut flora to prevent further episodes of infection.

Resistance to antibiotics will likely be one of the main public health problems of the next decade, according to some studies.

"C. auris resistance to medications is really unprecedented compared to other similar yeasts,” Woodworth said.

There were 12 clinical cases in Georgia as of the end of 2022, according to state data, but C. auris was only made nationally notifiable in 2018.  

Clusters of cases usually involve a hospital network, as opposed to a single facility, as patients transfer between long-term care facilities and acute care hospitals.  

That means outbreak detection, control, and remediation can be complicated since infection is rarely contained to a single hospital, Woodworth said.  

C. auris can survive on surfaces such as a bedside table for weeks and the fungus is resistant to some common disinfectants typically used in hospitals, which is pretty unusual with fungal pathogens.