
A Chicago woman fell victim to Candida auris, a drug-resistant fungus - dredmorbius
https://www.nytimes.com/2019/04/17/health/candida-auris-fungus-chicago.html
======
mherdeg
Johanna Rhodes, an infectious disease specialist at Imperial College London,
told the New York Times: "We are driving [the spread of antifungal-resistant
organisms] with the use of fungicides on crops." The Times also cited a theory
from Tom Chiller, head of the CDC's fungal branch, that C. auris has become
increasingly prevalent as the widespread use of azole fungicides has killed
off other fungi on crops.

So ... let's suppose I care about slowing the development of drug-resistant
fungi. As an individual, what can I do?

I basically buy into the claim that widespread overuse of antibiotic drugs in
humans has caused an increase of multi-drug-resistant bacteria and I'm
generally on board with limiting my own use of antibiotics (e.g. not asking a
physician for an antibiotic prescription for a minor illness that is most
likely viral). I'm not so sure I understand the literature on antibiotic use
in livestock and I happily eat meat without thinking about what drugs the
animals were given.

What should I do with respect to azole fungicides and my grocery-shopping
decisions? I don't currently see strong evidence that buying food marked
"organic" is better for health or the environment, but should this new-to-the-
public-consciousness information about azole fungicide use in crops change my
mind? Should I be trying to buy crops which were not made with the use of
azole fungicides? What kind IS that -- are those fungicides on the
permitted/proscribed list for things that carry the marketing label "organic"
in the grocery store, and do certain farming practices end up using a lot more
of this apparently irresponsible pesticide versus certain other practices?

I took a cursory look at this for about half an hour and could not figure it
out, even after trying to understand primary-source literature from the past
few years about C. auris and USDA rules. I also can't even tell if individual
consumer-level actions make a difference, or if it's not worth trying.

Admittedly science reporting is really tough but it's a little surprising that
nothing in the literature I could readily find clearly suggests what
researchers think consumers should do differently (if anything).

~~~
nickysielicki
> and I'm generally on board with limiting my own use of antibiotics (e.g. not
> asking a physician for an antibiotic prescription for a minor illness that
> is most likely viral).

I, on the other hand, have an illegal supply of powerful antibiotics and
antifungals sitting in my medicine cabinet. They're technically for fish, but
do the math: there are only a handful of factories making these pills in the
world, and the pills are indistinguishable. I don't feel guilty about it in
the slightest.

There has been a fundamental change in the role of doctors and healthcare
professionals in the past 30 years, and I don't like it. You can go to a
doctor, and you can both agree that you have a certain infection, and the
doctor will refuse to prescribe a drug which all parties know will cure the
infection. I think that's a new development in medical practice.

So that's why I have fish medicine. Because when I'm sick for 3 weeks and
still getting worse, fuck the greater good, I'm getting mine. And that's why
you should take fish medicine, too: because as long as there are people like
me, you're fighting a lost cause.

~~~
matthewmacleod
_You can go to a doctor, and you can both agree that you have a certain
infection, and the doctor will refuse to prescribe a drug which all parties
know will cure the infection_

That’s really not a thing that’s happening. You might find a doctor reticent
to throw antibiotics at minor infections, but that’s because of their side
effects rather than anything to do with antibiotic resistance.

In any case, even if there are a small number of people misusing antibiotics,
it’s likely that the effect of their use in farming is far more harmful in the
whole.

~~~
richardhod
indeed, it's mostly that they know which antibiotics and other drugs work on
which infections, and when they will not work at all. So many people demand
drugs for colds and flu, and it is only the incompetent doctor that will give
you antibiotics for viruses. Patients generally aren't good at diagnosis or
choosing correct treatment, even with their apparent certainties from google.

------
rellui
"First identified in the ear of a woman in Japan in 2009 (“auris” is Latin for
“ear”), the germ has spread around the globe, mostly appearing in hospitals
and nursing homes, where it afflicts people with weakened immune systems."

Looks like it managed to spread without much hindrance due to its immunity.
Wonder just how common it'll get since it's so hard to get rid of.

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Tharkun
Is this becoming a serious problem? Or is this just getting more press
attention suddenly? We've had outbreaks and near-hysteria of various sorts
(HIV, SARS, swine flu etc). But those seem orders of magnitude easier to
manage than this fungal infection. You don't need to tear down hospital rooms
after an HIV patient spent time in it.

~~~
microcolonel
The cases are accelerating, and the information is actively being suppressed
from the public (for what they see as good reasons, I guess). Something tells
me that candida auris will change the way hospitals are built and maintained.

~~~
simias
>The cases are accelerating, and the information is actively being suppressed
from the public (for what they see as good reasons, I guess).

Do you have any sources for these claims or is this tinfoil-hattery? What
would be these "good reasons" for suppressing information? And if the
information is unavailable, how do you know that "the cases are accelerating"?

~~~
true_tuna
The linked articles explicitly say that hospitals are not publicizing the
infections because they want to avoid panic. Previously rare fungal infection
showing up in five hospitals is a pretty significant uptick.

The fact that it’s extraordinarily hard to eradicate is notable as well. One
of the linked articles mentioned having to tear out ceiling tiles and flooring
to get at it.

~~~
dragonwriter
There is a difference between being reluctant to disclose information and
suppressing it; the article says the former, the poster recast it as the
latter.

~~~
URSpider94
The CDC and health department are specifically prevented from disclosing what
institutions have had outbreaks. That seems like “suppression”

------
hospitate
I was scrolling on Weibo the other day and came across a news story about a
killer fungus sweeping across the USA. Several deaths with 60% percent chance
of death, they said. Well that was certainly news to me so I googled it.
Nothing. Not a single shred of information. I wrote it off as shoddy Chinese
journalism.

~~~
snakeboy
I don't think anyone was really reporting on it notably until a big NYT[0]
article a few weeks ago.

[0] [https://www.nytimes.com/2019/04/06/health/drug-resistant-
can...](https://www.nytimes.com/2019/04/06/health/drug-resistant-candida-
auris.html?module=inline)

------
ars
Need to put Streptomyces noursei and Candida Auris in a petri dish together
and let them battle it out.

Hopefully the bacteria wins and we can create a new antifungal from the
results.

------
sctb
Related:
[https://news.ycombinator.com/item?id=19590180](https://news.ycombinator.com/item?id=19590180).

------
plutonorm
I currently have a ringworm infection on my leg, which hasn't responded to 3
different topical antifungals. Wondering if I am going to die...

~~~
mimac
I cured mine with 10vol.% lavender oil + 10vol.% thyme oil in carrier oil
(grapeseed oil). I couldn't be bothered by going to a doctor and it worked
fine. Essential oils are non-selectively toxic so do be careful.

~~~
rcMgD2BwE72F
>I couldn't be bothered by going to a doctor

Do you live in the USA?

I can't believe "going to the doctor" can still be a problem, unless you're in
war zone or one of the worlds' poorest countries but that doesn't apply to the
US, does it?

~~~
mimac
No, I live in the EU with full insurance, but going to a doctor would mean
going there during working hours, waiting a few hours, getting a script and
going to the pharmacy. Essential oils OTOH could be delivered by mail and even
though I had to pay for them convenience won out. But considering the
emergence of antifungal resistance it might have been a good choice in the end
;)

------
muktaakash
Did anybody tried to apply blackseed and garlic light deep - fried coconut oil
concoction? Just curious, sharing as it is our sub tropical Assam-Burma jungle
traditional remedy for anything and everything fungal infection since time
immemorial. Regards to all.

~~~
Raphmedia
The issue is that the fungus has entered their bloodstream.

~~~
hexane360
Seems to me like this problem:
[https://xkcd.com/1217/](https://xkcd.com/1217/)

------
GrryDucape
We need to end so-called semi private rooms. This fungus was apparently found
on the ceiling of a man that died of it. Sick people sharing rooms and toilets
is a recipe for disaster.

~~~
aitchnyu
What do you propose for hospitals who can afford only crowded wards and shared
toilets?

------
TausAmmer
Looks like nature is eliminating weak chains in any way possible.

------
jMyles
There is a comment in this thread downvoted and killed, but I think it's not
an entirely unreasonable question - and it's possible that someone here knows
the answer:

> Did anybody tried to apply blackseed and garlic light deep - fried coconut
> oil concoction? Just curious, sharing as it is our sub tropical Assam-Burma
> jungle traditional remedy for anything and everything fungal infection since
> time immemorial.

~~~
fzeroracer
I'm wondering if they tried chicken noodle soup. That's been my family's home
remedy for sickness and considering we seem to get better after every cold, it
has a 100% success rate.

To be less sardonic, it's an unreasonable question because it has zero
scientific basis. I've had naturopathic family members attempt to give things
to children that were definitely not safe in any shape or form.

~~~
aaronbrethorst
How about the idea that you can make tea from the leaves and bark of a willow
tree, and use it to treat fevers and aches and pains? Does that sound like a
ridiculous folk remedy?

~~~
fzeroracer
If you want to be remarkably disengenous and take my argument out of context,
sure.

But I will not stand for people recommending alternative medicine for
absolutely everything. I already had to deal with a family member doing just
that, forcing random concoctions of nonsense onto a family member suffering
from cancer and attempting to divert them from actual treatment. Especially
when they act like they're better than doctors and can't back up their
recommendations with anything remotely resembling research.

~~~
aaronbrethorst
_But I will not stand for people recommending alternative medicine for
absolutely everything_

I totally agree. The anti-vaxxers, for instance, are incredibly dangerous not
just to the health of individuals, but to modern civilization.

My point is that just because something is a folk remedy, or predates the
invention of the scientific method, doesn't mean it's inherently without
value. Rigorous scientific studies can and should be done on these sorts of
things—I don't think anyone should blindly accept a folk remedy, especially
one contraindicated by proper research.

But there is a certain dismissiveness amongst many folks like us of anything
not invented by the pharmaceutical industry that may do us all a disservice.

~~~
shawnz
> But there is a certain dismissiveness amongst many folks like us of anything
> not invented by the pharmaceutical industry

I don't think that's true. The cures don't need to be invented by the
pharmaceutical industry to be taken seriously. But they do need to be studied
and commercialized by the pharmaceutical industry to be taken seriously.

How could you take seriously a pharmaceutical product which is rejected by its
own industry? Obviously it's not commercializable in an honest way if that's
the case, or someone would have done it by now.

