First-line Therapy Tested

The CDC has identified the first cases of a dangerous, drug-resistant fungal infection in previously untreated people in the US.

There are also signs of transmission of the strains within health facilities, detailed in the description of 5 cases clustered in Washington, DC and Texas in yesterday’s CDC’s Morbidity and Mortality Weekly Report.
Especially concerning: The appearance of “pan-resistant” cases in people who hadn’t been treated with antifungal drugs before—meaning they caught an already pan-resistant strain. It also raises questions over how long the sole remaining first-line therapy, echinocandin drugs, will work.
More bad news:

  • 5 cases is likely an undercount—especially as the pandemic undercut already-spotty surveillance for other pathogens like C. auris.

  • The pandemic also fueled an increase in C. auris infections, which thrive in the same type of facilities where a number of people with severe COVID-19 underwent long-term care.


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