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38 cases of drug-resistant Candida auris fungal infection reported in Singapore since 2019

Two people in Singapore died from the fungal infection between January 2019 and March 2023.

38 cases of drug-resistant Candida auris fungal infection reported in Singapore since 2019

A 3D render of Candida auris cells (Photo: iStock)

SINGAPORE: Nearly 40 cases of Candida auris infections were reported to Singapore's Ministry of Health (MOH) over the last four years, the ministry said on Wednesday (May 29).

It was responding to CNA's queries after recent reports of the fungus - a form of yeast - spreading in hospitals in the United States.

According to the US Centers for Disease Control and Prevention (CDC), Candida auris is an emerging fungus that "presents a serious global health threat" –  it is often resistant to multiple antifungal drugs, difficult to identify with standard lab methods, and has caused outbreaks in healthcare settings.

MOH said that out of 38 Candida auris cases in Singapore between January 2019 and March 2023, two died from the infection.

There is no evidence of ongoing transmission in local hospitals, it added, noting that Candida auris infects severely ill or immunocompromised individuals.

Cases are usually found in hospital settings. Healthcare institutions in Singapore have prevention and control measures against any healthcare-associated infections, said MOH.

“All public hospitals also have facilities to isolate infected patients when necessary,” it added.

From 2012 to 2019, a total of 16 cases of Candida auris were reported across private and public hospitals, according to a parliamentary reply by then-Health Minister Gan Kim Yong in May 2019.

Singapore’s National Centre for Infectious Diseases (NCID) said it was aware of the spread of Candida auris in the US, calling it an "important drug-resistant fungal pathogen" that needs to be watched.

All hospitals in Singapore screen patients for Candida auris if they had overseas hospitalisation in the last year, NCID's clinical director Shawn Vasoo added.

He reiterated that the fungus does not typically cause infection in healthy people, but may do so in patients hospitalised for a long time and who have other risk factors.

Those with invasive medical devices or on prolonged courses of antibiotics are at a higher risk of catching Candida auris.

According to the CDC, people who get invasive Candida auris infections are often already sick from other medical conditions, so it can be difficult to know if they are infected. Only a laboratory test can diagnose such an infection.

The most common symptoms of invasive infection are fever and chills that do not improve after antibiotic treatment for a suspected bacterial infection.

“(Candida auris) can colonise the human skin without causing infection,” Dr Vasoo said.

"It is quite hardy and can persist for long periods in the environment and also be tolerant of commonly used disinfectants, and resistant to multiple types of antifungals, which are reasons why there are concerns over the rise of this yeast." 

The US Centers for Disease Control and Prevention (CDC) said on Mar 20 that the easily transmissible fungus was spreading rapidly across American healthcare facilities, with cases tripling between 2019 and 2021.

The number of cases rose from 330 in 2018 to 476 in 2019, 756 in 2020 and then 1,471 in 2021. 

In 2021, the number of cases resistant to drugs most often recommended to treat the disease also tripled, said the CDC. Some Candida auris strains are resistant to all three classes of antifungals used to treat fungal infections.

Other countries have also reported increased spread of the fungus, the CDC said.

Source: CNA/cm(jo)


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