November 23, 2021 | The U.S. Environmental Protection Agency (EPA) announced in mid-October 2021 a revision of its guidance on the evaluation of antimicrobial pesticides used against Candida auris (C. auris). This pathogen is a type of fungus (a yeast) that can cause serious infection and can spread readily among patients and staff in hospitals and other congregate health care settings (such as nursing homes). C. auris has developed resistance to what used to be the therapeutic impacts of major antifungal medications. (Resistance is a major and growing problem in health care and in agriculture, with the latter exacerbating the former.) To be clear, it is not all isolates (strains) of C. auris that have developed drug resistance—yet. Beyond Pesticides wrote in 2019: “Echoing the development of resistance in bacteria, there have lately been resistant fungi showing up in hospitals and labs, adding to the already considerable worry in the medical community about how to treat people who contract infections caused by resistant pathogens. Candida auris can be deadly; indeed, more than one in three patients with a serious C. auris infection of the blood, heart, or brain die from it, and nearly half of those who contract the infection die within 90 days. Immunocompromised people and infants are at high risk of lethality from these infections. The agency has a decades-long poor track record on this front. Back in 1990, the U.S. Government Accountability Office (GAO) issued recommendations, based on its review of EPA’s regulation of disinfectants, a document titled Disinfectants: EPA Lacks Assurance They Work. Adoption of organic agricultural practices can diminish the resistance problem, potentially helping to preserve important antibiotic and antifungal medicines for treatment of human infection. But EPA abdicates its responsibility “to protect human health and the environment” when it fails to address the issue of efficacy of pesticide products, causing downstream health, economic, and environmental harms. [Richtel, Matt and Jacobs, Andrew. “A Mysterious Infection, Spanning the Globe in a Climate of Secrecy.” The New York Times. 2019.]
