11 cases of Candida auris reported at Singapore public hospitals since 2012

11 cases of Candida auris reported at Singapore public hospitals since 2012

File photo of a strain of Candida auris from Wikimedia Commons
A strain of Candida auris cultured in a petri dish at a laboratory. (Photo: Wikimedia Commons / Shawn Lockhart - Centers for Disease Control)

SINGAPORE: Eleven cases of Candida auris infections at public hospitals have been reported between 2012 and 2019, said the Ministry of Health (MOH) on Tuesday (Apr 9). 

They were "isolated and sporadic" cases, said MOH, adding that two of those patients died and nine recovered.

"The cases were immediately isolated and contact tracing conducted by the hospitals had not identified any disease spread. The patients’ rooms were thoroughly cleaned and disinfected to remove the fungus," said the ministry in response to CNA's queries.

"No outbreak of C. auris infections has been reported to MOH."

Candida auris is a fungus that causes serious infections. It usually occurs in healthcare settings among patients with weakened immune systems or severe underlying diseases.

Treatment includes anti-fungal drugs, but some Candida auris infections have been multidrug-resistant. 

The ministry's response comes after a letter published last year in medical journal ANNALS highlighted three cases involving the fungus in Singapore.

The letter, written by Dr Tan Yen Ee and Associate Professor Tan Ai Ling from Singapore General Hospital's microbiology department, pathology division, called Candida auris an "emerging fungus that is of increasing global concern".

This is alarming, said the authors, as the fungus is commonly multidrug-resistant, with some isolates of the fungus displaying "pan-resistance" to available anti-fungal drugs.

The first case in Singapore was detected in 2012, said the letter, involving a 52-year-old Singapore-born woman who was transferred to Singapore from India following a road traffic accident.

The other two cases occurred in 2016 and involved a Bangladeshi man and another man from the United States. 

The first woman was discharged, while the Bangladeshi man left the hospital against medical advice. The American patient died.

In its response on Tuesday, the ministry said that healthcare institutions are required to report to MOH any outbreak of healthcare-associated infections, including Candida auris infections.

While Candida auris is not a legally notifiable disease in Singapore, it has been included in the updated list of pathogens for the public health laboratory surveillance programme since 2018 to enable a coordinated and broad-based response to infectious threats of public health importance, it added. 

WHAT'S THE RISK ASSOCIATED WITH CANDIDA AURIS INFECTION?

Those who are at highest risk of infection are patients with severe underlying diseases, or those who are exposed to medical procedures and devices such as urinary catheters and surgery, said MOH.

The fungus infects people who are severely ill and/or have compromised immunity, said the ministry. As such people are typically hospitalised, it is "unsurprising" that Candida auris cases have been found in hospital settings, it said.

The risk of Candida auris infection to a healthy person is "very low", it added.

Candida auris infection can spread through contact with a contaminated environment, equipment or other surfaces. It can also spread through contact with affected people. 

Early detection of patients infected with the fungus, as well as good infection prevention and control practices - such as meticulous hand hygiene and environmental disinfection - can prevent its spread, said MOH.

According to the US Centers for Disease Control and Prevention, specialised laboratory methods are needed to accurately identify C. auris. 

Conventional laboratory techniques could lead to misidentification and inappropriate management, making it difficult to control the spread of C. auris in healthcare settings.

Source: CNA/nc(gs)

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