Japanese fungus in UK hospitals

More than 200 people have been contaminated or infected with a potentially deadly strain of drug-resistant fungus during outbreaks at UK hospitals

Some 20 separate NHS Trusts and independent hospitals detected Candida auris (C. auris) in patients, with three hospitals tackling 'large' outbreaks of the pathogen.

First discovered in Japan, the family of yeasts can live on the skin and inside the body, causing complications in people with weakened immune systems.

Resistance

Public Health England (PHE) said doctors at one hospital were still dealing with an outbreak of the fungus, which is resistant to a commonly prescribed fungicidal drug.

Staff have been issued with new guidance on detecting and dealing with the fungus, including the 'intensive' disinfection of wards amid concern over the 'increasing experience of the complexities' infections are posing.

Meanwhile a biosafety unit at Porton Down in Wiltshire has been testing fungicidal activity of a variety of disinfectants and antiseptics.

'As at the beginning of July 2017, 20 separate NHS Trusts and independent hospitals in the United Kingdom had detected more than 200 patients colonised or infected with C. auris,' PHE said.

'Three hospitals have seen large nosocomial (within hospital) outbreaks that have proved difficult to control, despite intensive infection prevention and control measures, though two of these outbreaks have been declared over and one is seeing significantly fewer numbers of new acquisitions.

'More than 35 other hospitals have had patients known to be colonised with C. auris transferred to them.'

Minor infections

Official guidance states that infections are usually minor, while serious infections are rare.

PHE said there was no evidence that any of the infections had resulted in the death of a patient in the UK, although there were limitations to the data available.

It said most cases detected in the UK have been of colonised patients, while around a quarter of cases have been clinical infections – including 27 patients who developed blood stream infections.

Complications arise when the fungus enters the body or blood stream during medical treatment, such as the insertion of drips of urinary catheters, or a wound.

C. auris is resistant to the first-line antifungal drug fluconazole and the species can rapidly evolve to develop resistance.

The fungus was first identified in the ear of a patient in Japan in 2009 and has since caused prolonged hospital outbreaks in India, Pakistan, Venezuela, and Colombia.

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