In Brazil, clinicians have noticed a rise in Candida auris infections. Researchers believe that exhausted healthcare workers, overcrowded hospitals, and chaotic conditions have created a perfect opportunity for this fungus to spread. While C. auris is a normal part of the human microbiome, when it grows excessively, it can cause serious problems. If it enters the bloodstream it can cause a dangerous systemic infection called candidemia. Only a handful of COVID-19 patients in Brazil have been identified with the infection so far at a hospital in the state of Bahia in Northeast Brazil, but researchers are concerned there may be more to come.
"Nine other C. auris patients have since been diagnosed at the same hospital, some colonized [with the fungus in their bodies but it's not presently harming them] and others infected," said Arnaldo Colombo, head of the Special Mycology Laboratory at the Federal University of São Paulo (UNIFESP). "No other cases have been reported in Brazil, but there are grounds for concern. We're monitoring the evolutionary characteristics of C. auris isolates from patients at the hospital in Salvador, and we've already found samples with reduced sensitivity to fluconazole and echinocandins. The latter belong to the main class of drugs used to treat invasive candidiasis."
These cases have been reported in the Journal of Fungi.
Some research has suggested that mortality in candidemia patients can reach 60 percent; it's a dangerous complication and can be tough to get rid of.
"The species quickly becomes resistant to multiple drugs and isn't very sensitive to the disinfectants used by hospitals and clinics," Colombo said. "As a result, it's able to persist in hospitals, where it colonizes health workers and ends up infecting patients with severe COVID-19 and other long-stay critical patients."
COVID-19 patients in India are also turning up with mucormycosis, a fungal infection that can be deadly and is sometimes known as black fungus. While thought to be rare, the pathogen may be more common in India due to a variety of factors, including a humid climate that helps the fungus grow and a lack of access to good healthcare for many people.
Black fungus can grow in damp environments from soil to the human respiratory tract, and it can also infect wounds. In the worst cases, it can infect the brain, and the mortality rate may be as high as 54 percent. Intravenous antifungal drugs like Amphotericin B are usually used as a treatment, but it may take patients weeks to recover. That drug is also in short supply in India right now.
Over 3,200 cases of black fungus have been reported in five states in India so far.
Sources: AAAS/Eurekalert! via Fundação de Amparo à Pesquisa do Estado de São Paulo, CNN, Journal of Fungi