COVID-19 and Candida auris co-infection: an increasing threat

ABSTRACT

Candida auris has emerged in recent years as an important cause of hospital infection outbreaks around the world. C. auris is an intensive care unit (ICU) environmental colonizer and many hospital environments may harbor C. auris transmission. In addition, in 2020, other countries Guatemala, Mexico, Peru, Panama, Colombia and the United States - documented cases of C. auris infection, mostly in patients with a history of COVID-19 infection, highlighting that in the first three countries no isolates were reported prior to this period. Therefore, it is noteworthy that both COVID-19 and C. auris share at least six characteristics that should be highlighted (a) both pathogens may remain on surfaces, including hospital floors, beds, bedrails, poles, air conditioners and windows;(b) both may present high mortality rates;(c) both pathogens require standard laboratory methods for diagnosis;(d) both present treatment difficulties due to multidrug resistance (C. auris) or no effective medical therapy (SARS-Cov-2);(e) both are globally distributed causing outbreaks in healthcare facilities;(f) both present risk factors, including in cases of mechanical ventilation, diabetes mellitus, protracted ventilator-assisted management, immunosuppression, chronic kidney disease, etc. There is much to be learned about these infectious diseases, particularly in countries with poor hygiene, high population density and intense migratory flows, not to mention international travel contributing substantially to both pandemics. Vigilance practices by hospital committees for infection control and routine diagnostic processes for determining C. auris fungal infection in COVID-19 patients should be implemented. Modern diagnostic tests must be made available worldwide, as well as access to adequate antifungal therapy to manage C. auris infection. All of the aspects mentioned will effectively contribute to reducing mortality by COVID-19 and enable monitoring the emergence of C. auris.