Pernambuco sets up TASK FORCE to prevent CANDIDA AURIS from spreading in hospitals

To reinforce the investigation, prevention and control actions of the spread of the superfungus Candida auris, Pernambuco created, this Thursday (25), a task force to face the outbreak.

The technical committee has the participation of managers from the Health Department of Pernambuco (SES-PE), in addition to representatives from the Pernambuco Health Surveillance Agency (Apevisa), the Central Public Health Laboratory of Pernambuco (Lacen-PE) and the Society Pernambuco of Infectology.

The aim is to monitor the scenario and act in an integrated manner against the superfungus, which is a cause for alarm around the world and has already been identified this year in three patients in Pernambuco: two in public hospitals and one hospitalized in a private service.

SUPERFUNGUS IN PERNAMBUCO: SEE PROFILE OF PATIENTS COLONIZED BY CANDIDA AURIS

You three patients (all are male), according to SES, they are in stable health. Understand the profiles, according to folder information:

1. 48 year old patient he is admitted to Hospital Miguel Arraes, in Paulista, in Greater Recife. The unit belongs to the public network in Pernambuco. He had Candida auris confirmed on May 11th.
2. 77 year old patient it’s in the Hospital of the Tricentennial, located in Olinda, in Greater Recife. The unit belongs to the public network in Pernambuco. Confirmation of the Candida auris superfund was given on May 14th.
3. 66 year old patient and is hospitalized at the Real Hospital Português (RHP), a private network in Recife. He receives assistance for treatment of chronic kidney disease and should be discharged soon to return to the hemodialysis in another health unit, with isolation. The report of JC contacted the RHP communication advisory, which informed that it will not comment on the case and that all disclosure will continue to be made by SES.

Committee members will discuss strategies to identify and prevent candida auris infections in health services in Pernambuco.

A Secretary of Health of Pernambuco, Zilda Cavalcantiensures that SES-PE has acted preventively, monitoring all suspicions of the superfungus.

“We decided to create a committee with several scientific entities to monitor each case closely, with all the particularities. The secretariat is committed to ensuring that the population is safe and remains vigilant to avoid new cases.”

This is the second outbreak of Candida auris in Pernambuco. The first occurred between December 2021 and September 2022. During this period, according to SES-PE, the State registered, at the Hospital da Restauração, in Derby (central area of ​​Recife), 47 cases: 46 colonized and 1 infected by the fungus.

Patients with Candida auris may not show signs related to superfungus infection, but have a picture suggestive of colonization. The difference between both conditions is that colonization indicates that the patient has the fungus, but does not have an infection – and this occurs when Candida auris is present in the bloodstream.

“You three cases of Candida auris detected this year are colonization: they do not have signs of an infectious disease, but rather symptoms of the diseases or conditions that led to their hospitalization, such as chronic kidney disease or neurological sequelae due to a stroke (cerebrovascular accident)”, clarifies sanitarian Karla Baêta, general director of the Apevisa.

“We’ve been monitoring the Restoration Hospitalwhere there were cases last year, and there is currently no confirmation of patients colonized or infected by Candida auris in this health unit”, guarantees Karla.

SUPERFUNG CANDIDA AURIS IN PERNAMBUCO: PATIENTS EXPOSED IN HOSPITALS ARE MONITORED

The Health Department of Pernambuco (SES-PE) guarantees that it has been working on blocking and controlling the spread of Candida auris.

In the sectors where the three patients from this year’s outbreak are hospitalized, an immediate intensification of cleaning and disinfection of environments was established.

To detect possible new cases, professionals continue the search and diagnostic investigation of all patients who were exposed to the same hospitalization environments as the patients.

With the identification of the current outbreak of candida auris in Pernambuco, the State Department of Health (SES) informs that it monitors 180 patients who had contact with environments where the three people with confirmed diagnosis passed of the superfungus this month.

“Now, we do monitoring of 180 people who passed through the same hospital areas visited by the three patients diagnosed with Candida auris. These 180 are also patients from the health units who were in the same environment or had contact with the same surfaces”, informs Karla Baeta.

It is important to explain that these 180 patients, according to Karla, do not currently have a diagnosis of Candida auris, but go through the monitoring for surveillance, prevention and control of possible superfungus infection.

“Are culture collections performed with swab. The protocol calls for three tests to be performed, with an interval of 72 hours between them. On the third negative result, the patient no longer needs to be monitored and is discharged”, explains Karla.

You Health professionals who had contact with the three confirmed cases do not need to undergo this surveillance because, according to the general director of Apevisa, they follow the individual and collective protection protocols.

SUPERFUNGUS IN PERNAMBUCO: CANDIDA AURIS CAN CAUSE SERIOUS CASES OF SEPTICEMIA

The infectologist Flavio de Queiroz Telles Filhocoordinator of the Mycology Committee of the Brazilian Society of Infectology (SBI), explains that the candida auris occurs as nosocomial infectionwhich can cause severe cases of septicemia (condition of exaggerated response to an infection, whether by bacteria, fungi or viruses) or just colonizing the skin of patients. “But it easily stays inside hospitals where it is detected. It is very difficult to be eradicated”, she stresses.

The biggest problem related to the superfungus candida aurisaccording to the infectologist Filipe Prohaskais that this infectious agent is multiresistant to several antifungal drugs. “It is an exclusively hospital micro-organism”, says the doctor, who is concerned about the aggressive potential of this fungus.

Studies indicate that up to 90% of the isolates of candida auris they are resistant to the following medications: fluconazole, amphotericin B or echinocandins.

Another cause for concern is that the candida auris it can remain viable for long periods in the environment (weeks or months) and is resistant to several disinfectants, including those based on quaternary ammonium.

The infectologist Arnaldo Lopes Colomboa professor at the Federal University of São Paulo (Unifesp) and a national reference in fungal contamination, informs that the treatment of candida auris it is made with antifungal.

“The only problem is that it’s a microorganism capable of persisting in the hospital environment for a long time. If adequate disinfection measures are not instituted, the fungus can colonize these patients for a long time and become resistant to medications’ warns the doctor.

SUPERFUNGUS CANDIDA AURIS: WHAT IS CANDIDA AURIS AND WHAT ARE THE SYMPTOMS?

A candida auris is an emerging fungus that represents a serious threat to public health. It can cause bloodstream infection and other invasive infections.

It can be fatal, especially in immunosuppressed patients or patients with chronic diseases.

SUPERFUNGUS CANDIDA AURIS: HOW IS CANDIDA AURIS TRANSMITTED?

A transmission of the superfungus Candida auris occurs directly from patient care equipment and materials with candida auris (such as stethoscopes and thermometers, among others), but nothing prevents this transmission from also happening through the hands of health professionals. Therefore, hand hygiene needs to be respected.