Covid 19, C. Auris and Abortion

Covid 19 is still widespread in the world. Countries including the US are pushing for another shutdown. Candida Auris is a new emerging multidrug-resistant fungus that is becoming a problem. The US elections are at complicated crossroads. Poland has tightened their abortion laws, citizens react in protest. 

Global and US Covid Stats

Cases: 50,123,657 Deaths: 1,255,392

US: 10,166,227

Deaths: 243,186 Recovered: 6,433,976

US Case Count

  1. Texas – 1,011,237
  2. California – 967,468
  3. Florida – 837,077
  4. New York – 562,036
  5. Illinois – 477,978

Candida Auris 

10/26 case count 1,364

-NY and IL have the most

Candida Auris is an emerging fungus that presents a serious global health threat. CDC is concerned about C. Auris for three main reasons:

  • It is often multidrug-resistant, meaning that it is resistant to multiple antifungal drugs commonly used to treat Candida infections. Some strains are resistant to all three available classes of antifungals.
    • Think of MRSA – methicillin-resistant Staphylococcus Aureus 
  • It is difficult to identify with standard laboratory methods, and it can be misidentified in labs without specific technology. Misidentification may lead to inappropriate management.
  • It has caused outbreaks in healthcare settings. For this reason, it is important to quickly identify C. Auris in hospitalized patients so that healthcare facilities can take special precautions to stop its spread.

From the CDC website: “We don’t know if patients with invasive C. Auris infection are more likely to die than patients with other invasive Candida infections. Based on information from a limited number of patients, 30–60% of people with C. Auris infections have died.”

Hospital protocols for C. Auris

  1. No stethoscopes, equipment, or other items from outside rooms. 
  2. Proper PPE (gown, gloves) Can’t enter without proper PPE for a “quick IV adjustment” 
  3. Wipe down the work area with Oxivir or bleach x1 a shift. This includes IV pumps, computers, isolation cart & other services. 
  4. No C-Auris patient should be paired with post-op patients, ECMO, CRRT, or other high-risk patients
  5. Wash your hands with soap, 20-sec scrub

How is it diagnosed?

  • C. Auris infections are usually diagnosed by culture of blood or other body fluids. However, C. Auris is harder to identify from cultures than other, more common types of Candida.
  • It can be confused with other types of yeasts, particularly Candida Haemulonii.

Who is at risk?

  • People who have recently spent time in nursing homes and have lines and tubes that go into their bodies, such as breathing tubes, feeding tubes, and central venous catheters.
  • Risk factors for Candida Auris infections are generally similar to risk factors for other types of Candida infections.
    • Recent surgery
    • Diabetes
    • Broad-spectrum antibiotic and antifungal use. 
    • Infections have been found in patients of all ages, from preterm infants to the elderly.

How do we treat it?

  • Most C. Auris infections are treatable with a class of antifungal drugs called echinocandins. Some C. Auris infections have been resistant to all main classes of antifungal medications, making them more difficult to treat. 
    • In this situation, multiple classes of antifungals at high doses may be required to treat the infection.

Death rate

  • ⅓ people die due to complications caused by C. Auris
  • C. Auris infections are more likely to die than patients with other invasive Candida infections.
  • 30–60% of people with C. Auris infections have died. However, many of these people had other serious illnesses that also increased their risk of death.

How did it spread

  • CDC conducted whole-genome sequencing of C. Auris specimens from countries in the regions of eastern Asia, southern Asia, southern Africa, and South America. 
    • Whole-genome sequencing produces detailed DNA fingerprints of organisms. 
  • CDC found that isolates within each region are quite similar to one another, but are relatively different across regions. These differences suggest that C. Auris has emerged independently in multiple regions at roughly the same time.

Poland Moves to Near Abortion

    • Poland’s highest court ruled that abortions due to fetal defects are unconstitutional, moving the country towards a near-total ban on terminations and sparking angry protests in the capital Warsaw.
    • Warsaw Mayor Rafal Trzaskowski said more than 100,000 people were in attendance.
    • Police detained 37 people Friday, the vast majority of whom were football hooligans, Sylwester Marczak, spokesman for the Warsaw Police headquarter. Taking into account the huge number of participants, it was a “very peaceful” protest, he added.
  • Around 98% of abortions in Poland had been conducted as a result of fetal defects, meaning the ruling bans virtually all termination procedures taking place in the country. It could force women to carry a child even if they know the baby will not survive childbirth

 

Work Cited

  1. https://www.cdc.gov/fungal/candida-auris/candida-auris-qanda.html#:~:text=auris%20first%20reported%3F-,C.,to%201996%20in%20South%20Korea
  2. https://www.cnn.com/2020/10/31/europe/poland-abortion-protests-scli-intl/index.html
  3. https://www.cnn.com/2020/10/22/europe/poland-abortion-fetal-defect-ruling-intl/index.html
  4. https://www.cdc.gov/fungal/candida-auris/candida-auris-qanda.html#:~:text=auris%20infection%20are%20more%20likely,increased%20their%20risk%20of%20death

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