As a drug-resistant fungal disease, Candida auris, adapts to the warmer climate, cases of it rise; up 214% in Kentucky in 2022

Cases of a potentially fatal fungal disease called Candida auris have increased by 1,200 percent since 2017 and the warmer climate could be to blame, Camille Fassett reports for The Associated Press and Grist.

All of Kentucky's 29 clinical cases of C. auris were reported in 2021 and 2022. However, there was a 214% increase between the years, with seven in 2021 and 22 in 2022, according to the Centers for Disease Control and Prevention. 

Fungal disease expert Arturo Casadevall, a microbiologist, immunologist and professor at Johns Hopkins University, told Fassett that humans normally have tremendous protection against fungal infections because of our temperature. 

“However, if the world is getting warmer and the fungi begin to adapt to higher temperatures as well, some … are going to reach what I call the ‘temperature barrier’,” he said, referring to the threshold at which mammals’ warm bodies usually protect them from infection.

In other words, Fassett writes, "Over time, humans may lose resistance to these climate-adapting fungi and become more vulnerable to infections. Some researchers think this is what is happening with C. auris." 

And while C. auris is not usually dangerous for healthy people, it can be for older patients, people with pre-existing medical conditions and people in health-care settings. The death rate is estimated to be between 30% and 60%, according to the CDC. 

The pathogen was first identified 14 years ago in Japan and early on most cases in the U.S. were linked to people who had traveled from other places, Meghan Marie Lyman, an epidemiologist for mycotic diseases at the CDC, told Fassett. Now, she said, most cases are acquired locally, generally spreading among patients in health-care settings.

"In the U.S., there were 2,377 confirmed clinical cases diagnosed last year," Fassett reports. She adds, "In the U.S., the most cases last year were found in Nevada and California, but the fungus was identified clinically in patients in 29 states. New York remains a major hot hotspot."

Dr. Luis Ostrosky, a professor of infectious diseases at McGovern Medical School at UTHealth Houston, told Fassett that he thinks C. auris is “kind of our nightmare scenario.”

“It’s a potentially multidrug-resistant pathogen with the ability to spread very efficiently in health care settings,” he said. “We’ve never had a pathogen like this in the fungal-infection area.”

The problem is so bad that the CDC issued a news release in March, calling the fungus "an urgent antimicrobial resistance (AR) threat" and noted that it "spread at an alarming rate in U.S. health-care facilities in 2020-21." 

"CDC has deemed C. auris as an urgent AR threat, because it is often resistant to multiple antifungal drugs, spreads easily in health-care facilities, and can cause severe infections with high death rates," the release says.

The article is published in Grist, an online journal of environmental news and commentary, as part of a collaboration with AP called Climate Connections, to explore how a changing climate is accelerating the spread of infectious disease around the world, and how mitigation efforts demand a collective, global response.