Deadly fungal ‘superbug’ spreading in NICUs

A new icddr,b study has found frequent transmission of the highly drug-resistant fungal "superbug" Candida auris in neonatal intensive care units (NICUs) of hospitals.

The findings align with another recent icddr,b study that reported no community-acquired C auris among newly hospitalised patients.

C auris can live harmlessly on the skin but may enter the bloodstream, causing deadly infections.

The study, conducted with the Institute of Epidemiology, Disease Control and Research and supported by the US Centers for Disease Control and Prevention, was published recently in Microbiology Spectrum, icddr,b said in a Facebook post yesterday.

Between August 2021 and September 2022, researchers studied patients in the NICUs of one public and one private hospital in Dhaka. Of 374 patients, 32 (9 percent) were colonised with C auris, and one (0.3 percent) developed a bloodstream infection.

Among the colonised patients, 44 percent were colonised at enrolment, and 56 percent became colonised after admission. Of the 14 patients colonised on admission, 13 were admitted or moved from another hospital setting, while only one came from home.

Seven (22 percent) of the 32 colonised patients, including the one with bloodstream infection, died.

While only three (9 percent) showed multidrug resistance, 82 percent were resistant to fluconazole, the first-line treatment for invasive fungal infections.

Also, 81 percent of the colonised cases had undergone delivery by caesarean section.

"This study provides important evidence of transmission of this superbug among critically ill and vulnerable patients in NICUs," said Fahmida Chowdhury, associate scientist and lead of the AMR Research Unit of the Infectious Diseases Division at icddr,b.

The authors recommend regular cleaning of hospital surfaces with chlorine-based disinfectants and improved hand hygiene among healthcare workers to limit persistence and spread within NICUs and other hospital settings.