A super-resistant fungus is detected in seven hospitals of the Madrid Health Service (Sermas), according to the Madrid Society of Clinical Microbiology (SMMC). This is Candida parapsilosis, an emerging pathogen associated with more difficult treatment and the appearance of outbreaks.

Its presence has also been confirmed in other centers in Spain.

What is 'Candida parapsilosis'?

Candida parapsilosis is a type of fungus, classified within the genus Candida, that emerges on the skin of healthy people, on the genital mucous membranes or in the digestive tract.. Cases that arise during hospital stays are due to the use of medical implants, catheters, and parenteral administration routes.

It tends to reproduce more easily in immunosuppressed patients, the elderly, and newborns.. Also at greater risk of the fungus reproducing and causing candidiasis are those who have been exposed to antibiotics for a long time, and those who are hospitalized, especially those who have undergone gastrointestinal surgery.

Is it a dangerous mushroom?

The great resistance to fluconazole, the antifungal used for the prevention and cure of fungi, and its “great transmissibility” are the factors that have caused the alarms to go off.. This is how Patricia Muñoz García, president of the SMMC, explained it.

This species of fungus has a reduced susceptibility to treatment with echinocandins and is considered sensitive to other families of drugs, such as polyenes (amphotericin B) and triazoles (fluconazole, voriconazole, itraconazole, posaconazole and itraconazole).

Where have they been detected?

The first cases of this type of fungus in Spain were detected in the Son Espases Hospital in Palma de Mallorca and later in Barcelona before arriving in Madrid, where it has been detected in seven hospitals.. However, the origin of these strains in the different cities is not related to each other.

“The clones that have existed in Mallorca, Barcelona, or Madrid are independent clones, it is not that one is derived from another and they are not patients who have previously received antifungal treatment and develop resistance,” explained the head of the Health Service. Clinical Microbiology and Infectious Diseases at the Gregorio Marañón General University Hospital.

What effects does it have on health?

It is considered an important emerging pathogen associated with a wide clinical spectrum of infections:

• Superficial: reddish and painful rashes mainly on the nails (onychomycosis), skin, even the middle ear.
• Systemic infections: irritation usually appears in the internal membranes of the body or in the digestive system, accompanied by severe abdominal pain.. Endocarditis, peritonitis, endophthalmitis, and joint disorders occur, usually occurring in association with invasive procedures or prosthetic devices.

Which is the treatment?

They may suffer from mild infections but, if left untreated, complications may occur.

Once the infection is known, antibiotics must be eliminated and, in the case of women, also contraceptives.. Treatment for these patients must be intravenous.. It is not clear that it produces greater mortality.

At the moment, clinical studies are being developed to determine its virulence, although what has already been demonstrated is its persistence, “the patient transmits and remains colonized for a long time,” says the microbiologist.

How to control it?

The specialist has emphasized that it is essential to control contagion to isolate patients who are transferred from hospital and to look for Candida Parapsilosis resistant to fluconazole both in patients and in the center.. “In my opinion, it is crucial to detect the first patient who enters our hospital very early and thus prevent its spread.. Once it enters the hospital, it is difficult to get rid of it,” indicated the specialist.

In the specific case of the Community, the president of the SMMC has indicated that one hospital is achieving it, but in the rest “the incidence is really increasing a lot and it is already being transmitted to Burgos and also to Ávila”, as is evident in the CANDIMAD study led by Jesús Guinea and Pilar Escribano with the participation of the SMMC.