Ugo Giguere, The Canadian Press
MONTREAL — A dangerous fungus known for its resistance to antifungal treatments has been detected at the Pierre-Boucher Hospital in Longueuil, confirmed the Montérégie-Est Integrated Health and Social Services Center (CISSSME).
The CISSSME specifies that two cases of patients carrying Candida Auris have been detected since September 8. Neither of these two patients, however, would have developed a dangerous yeast infection.
On this date, a first person suspected of carrying the fungus was placed in isolation as well as “all his close contacts”, confirmed by email the media relations advisor Caroline Doucet.
Other precautionary measures have also been deployed, according to the CISSSME, including a series of instructions to be followed by the staff of the unit concerned. These include wearing personal protective equipment, washing hands and frequent disinfection of affected surfaces and equipment.
It is assured that all patients who have been in contact with the two carrier cases have undergone screening tests and the CISSSME considers that the Pierre-Boucher Hospital remains a safe place of care.
Federal Health Minister Jean-Yves Duclos reacted to the news by saying he was concerned about the presence of this pathogen in Quebec as elsewhere in the country. He says he has asked federal public health to speed up the collection of information from the provinces in order to obtain a better epidemiological portrait of the situation.
A microbiologist-infectiologist specialized in medical mycology, Dr. Simon F. Dufresne, affirms that it is quite possible that Candida Auris is more present than we believe. However, he considers that the current equipment in Quebec makes it possible to identify the different strains of Candida quite well and that never before has the Auris form been detected.
All experts in the field have been expecting the first cases to be reported in the province for about five years, reveals Dr. Dufresne.
An article in the “Canada Communicable Disease Report”, dated November 2018, published by the Public Health Agency of Canada, already warned doctors about the possible presence of Candida Auris. It calls for vigilance and reminds us of the obligation to report cases to public health.
What is Candida Auris?
It is a yeast (a fungus) identified a little over a decade ago, as explained by the mycologist and director of the Center of Excellence for Genetic Research of Infectious and Immune Diseases at the University Center for McGill Health (MUHC), Dr. Donald Vinh.
From the outset, it should be noted that a person carrying Candida Auris will not even realize it since the fungus can colonize the skin without symptoms. However, the presence of the pathogen becomes a serious problem if it enters the blood. This is called candidemia.
“When that happens, these patients are in trouble!” Admits Dr. Vinh bluntly. Infected people become seriously ill. We then speak of fever, blood pressure that drops drastically, respiratory problems and even organs that can fail.
These patients should be promptly hospitalized and ideally treated in an intensive care unit. The other major issue is that this fungus is resistant to currently known treatments.
Dr. Vinh mentions that there are four classes of antifungal drugs for humans, three of which are more frequently used because the fourth causes severe side effects. The catch is that Candida Auris is resistant to all three treatments.
“We must turn to more innovative treatments, such as combinations of antifungals”, describes the one whose work focuses on another strain of the Candida family.
Regarding the transmission of Candida Auris, Dr. Simon F. Dufresne reveals that we are swimming in the unknown. If we know that contamination can pass through direct or indirect contact, we have no data on the duration of contact or the necessary proximity. On the other hand, we know that the transmission is done quite easily.
“What you see from the experience of other countries is that when there starts to be a lot in a hospital or in the hospital environment, there seems to be a lot of patients who become colonized. So, it seems quite persistent and quite easy to be colonized if there is an active outbreak, but it’s hard to be more precise than that,” observes the specialist affiliated with the Maisonneuve-Maisonneuve Hospital Research Center. Rosemount.