There’s a new superbug on the loose. Candida auris was first described as a pathogen in 2009, when it was found infesting a Japanese woman’s ear (whence the auris) and in the decade since, it has been reported in 32 countries, including India and Pakistan. A hardy fungus, undeterred by antifungals, it may have killed a third of the several hundred people it has infected, and is at the new threat horizon of drug-resistant microorganisms. Sulpha drugs and penicillin liberated the human race from the tyranny of microbes, which used to casually cut short lives. Easily accessible antimicrobials made possible an era of improving public health, which changed the fortunes of nations and, arguably, altered the course of history. But now, an excess of access threatens to send us back to the dark times before penicillin, when ordinary micro-organisms — even soil bacteria — could slay the weak at will. Candida auris has gained infamy as a hospital-acquired infection, and like other resistant organisms, preys on people with poorly developed or compromised immune systems, including newborns, the elderly and diabetics. In a few decades, they could represent a greater threat to life than cancer.
It’s anthropogenic Darwinism at work. Drug-resistant strains of microorganisms commonly develop from flawed prescription regimes, a matter of concern for decades. In affluent populations, they may be caused when patients demand overmedication. But slums in poor countries probably yield a richer crop, with patients buying antimicrobials over the counter from untrained shopkeepers. The method is hit-or-miss, a full course of medicines is rarely taken, and the bugs that survive are those resistant to medication. Over time, the efficacy of the antimicrobial can only diminish. But the cause for the Candida auris rampage lies deeper, in the over-use of antifungals in agriculture and animal husbandry. This has wiped out whole species, giving hitherto fringe species room to flourish. The new superbug is a country cousin of the well-known Candida albicans, which causes the oral infection called thrush. But the hitherto obscure organism now represents a far greater threat to humans.
Whether resistance is of medical or agricultural origin, the solution is the same: Public education against the arbitrary use of antimicrobial drugs. It did not work earlier, when it was a largely theoretical issue. But now that organisms like Candida auris are actually killing patients and contaminating entire hospital wards, as it has done in the US, UK and Spain, audiences will be more receptive.
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