SERMO doctors are discussing drug resistant bacteria including Candida auris, which “can cause invasive infections, is associated with high mortality and is often resistant to multiple antifungal drugs,” according to a new CDC report.
This morning the Centers for Disease Control revealed an investigation into the first seven reported cases of a globally emerging invasive, multidrug-resistant fungus in the U.S. called Candida auris. First discovered in 2009 in the ear canal discharge of a Japanese patient, C. auris infections have now been published in Colombia, India, Israel, Kenya, Kuwait, Pakistan, South Africa, South Korea, Venezuela, and the United Kingdom. Today’s report from the CDC describes the first seven reported cases in the States as of August 2016. Data suggests that C. auris may have occurred in health care facilities in the U.S. and “demonstrate the need for attention to infection control measures to control the spread of this pathogen.”
As the report outlines, the emergence of C. auris cuts straight to the heart of several public health concerns, including fears about multi-drug resistance and the role which hospitals play in developing and sharing these strains. In the case of C. auris, single hospitals seem to be connected to multiple cases: one hospital in Illinois was connected to two cases, and one of two patients in a New Jersey hospital seems to have brought C. auris to another hospital in Maryland.
SERMO doctors from around the world have been discussing the role of hospitals in multi-drug resistance, albeit not about C. auris until the news broke this morning, for years. A 2015 SERMO poll showed that a plurality of U.K. doctors felt the government should shorten trial duration to expedite drug development to prevent drug-resistant bacterial outbreaks. Earlier this year, upon learning that nearly a third of antibiotics prescribed in the U.S. are unnecessary (47 milllion prescriptions), SERMO doctors opined on the biggest drivers of unnecessary antibiotic prescriptions:
Conversations began late last week about how doctors can support antimicrobial stewardship – what the Infectious Disease Society of America defines as “coordinated interventions designed to improve and measure the appropriate use of antimicrobials by promoting the selection of the optimal antimicrobial drug regimen, dose, duration of therapy, and route of administration.”
We will be diving headlong into this topic in our next Poll of the Week, and we expect members of SERMO to continue their discussion of the role of doctors, and what can and should be done around multi-drug resistance moving forward. It is a complex issue which is sure to drive strong commentary – as a Venezuelan doctor recently noted, “Doctors have a share of responsibility, but we must be clear that in many of our countries the sale of antibiotics is free. And patients and self-medicate that contribute the medicine outlets. In addition, of course, the schemes are incomplete or broad-spectrum antibiotics in viral pathologies for example.” Check back at the SERMO blog for updates about this upcoming poll and discussion soon.