Combating Candida auris: Dr. Mary Kiran Danni's Insights on the Superbug
In this feature on DocsCopy for MedBound Times, we are delighted to present Dr. Mary Kiran Danni, an accomplished medical professional with an MBBS from Kanyakumari Government Medical College, Asaripallam, Tamil Nadu, India. She also holds an MD in Microbiology from Sri Ramachandra Institute of Higher Education and Research, Chennai, India, and is currently pursuing her Ph.D. at the same institution.
In an insightful interview with Dr. Nirainila Joseph, Dr. Mary Kiran Danni shares her profound interest in microbiology, particularly her research on Candida auris for her Ph.D. She discusses the challenges she faces in this research, its future prospects, and how her findings translate to real-world applications. She also highlights the threat posed by Candida infections and strategies for managing them. Additionally, she emphasizes the importance of raising public awareness about this infection.
Dr. Nirainila Joseph: Could you start by introducing yourself and giving us a brief overview of your educational and professional background?
Dr. Mary Kiran Danni: Hi. I am Dr. Mary Kiran Danni, MD. After completing my MBBS degree, I chose to do my MD in Microbiology. Currently, I am doing PhD on Candida auris, which is an emerging fungus commonly causing disease in ICU patients.
Dr. Nirainila Joseph: What motivated you to pursue a non-clinical postgraduate stream over a more traditional clinical path? Can you share what drew you to the field of microbiology?
Dr. Mary Kiran Danni: As medical students, we are introduced to the world of medical microbiology in our 2nd year. The fact that these microscopic organisms have developed themselves into formidable opponents to our health was both fascinating and terrifying at the same time. Since then, I have been appreciative of this field of medicine. Like most of the medical graduates, I was initially inclined towards clinical practice, more so because, I was not exposed to how an MD Microbiology worked. During our internship days in MBBS, we did not get a chance to work closely in this part of the hospital, compared to the clinical departments. Only while exploring my options during PG medical counselling, I learnt more about a clinical microbiologist's work through some friends and decided that this is what I'll do for the rest of my career. Though the decision was last minute, I began enjoying Microbiology as soon as I started my postgraduation journey.
Dr. Nirainila Joseph: Your journey into the field of medical microbiology is inspiring. Now, lets move on to your Ph.D. journey. Can you explain what Candida auris is and why it has become a significant concern in the field of microbiology? Why did you choose Candida auris as the focus of your Ph.D. thesis?
Dr. Mary Kiran Danni: Like I said, I am both fascinated and terrified of microbes. The latter is mainly because of the emergence of multidrug resistance. Resistance is when a bacteria, fungus or virus develops its own mechanism to evade the action of antibiotics and survives despite therapy. Candida auris is one such multidrug-resistant fungus, that was first reported only in 2009. But within a decade and a half, it has risen to prominence as one of the most commonly isolated fungi among Intensive Care Unit (ICU) patients. It has been causing a silent epidemic among hospitalized patients. It is a significant concern to global health itself, which is why abundant research is needed on Candida auris. The more, the better.
Dr. Nirainila Joseph: Can you give us an overview of your PhD research on Candida auris?
Dr. Mary Kiran Danni: The main focus of my PhD is on identification of Candida auris directly from patient sample. I am working on two methods to achieve this. One is by a simpler, conventional, cost-effective technique and another more sensitive, faster, molecular technique. Each of them will be useful in different hospital setups. Because proper treatment can be started only after a correct diagnosis can be made. Apart from identification, I am also analyzing the clinical and antifungal profile of Candida auris infections. I am also studying the genome of some of these isolates.
Dr. Nirainila Joseph: With research being a long and strenuous journey, what challenges have you faced in studying Candida auris, and how have you overcome them?
Dr. Mary Kiran Danni: Working on the diagnostic technique for Candida auris was the most challenging part of my work. But with the help of my mentor, I overcame that with trial and error. I think it's the same with research in general. We learn from mistakes until we get a satisfactory result. Another challenging aspect for me is that a lot of research is happening on Candida auris and it was sometimes discouraging to compare my work with others from developed countries. But it is important to remember that medical research is a service towards global health and any research done properly, will be useful in some way and is a step towards a better future.
Dr. Nirainila Joseph: Are there any specific skills or experiences from your undergraduate and postgraduate education and clinical training that have proven particularly valuable in your research?
Dr. Mary Kiran Danni: Being a doctor, I was able to understand the clinical profile of patients suffering from Candida auris Candidemia in a better way. It was easier for me to categorize and analyze the risk factors because of my clinical knowledge. All other aspects of my study were microbiology related and I acquired those skills only during MD.
Dr. Nirainila Joseph: Based on your current research, what do you see as the next steps or future directions for research on Candida auris?
Dr. Mary Kiran Danni: Elaborate studies are being conducted on Candida auris, worldwide. Compared to when I began my work in 2019, there has been a lot of improvement in understanding and tackling this elusive organism. My study will be very helpful in earlier diagnosis and in understanding the regional pattern of this organism, in terms of antifungal resistance and genetic origin of the circulating strains. This latter data can be used further in learning about its genome.
Dr. Nirainila Joseph: That sounds exciting! How does your research translate into improvements in patient care, public health initiatives aimed at reducing the spread of infectious diseases and infection control policies in healthcare settings?
Dr. Mary Kiran Danni: As data on Candida auris emerges from different parts of the world, governments, and healthcare advisories are framing diagnostic policies, treatment protocols, and disinfection agendas based on them. I believe my study will add important points to this data and will be translated into useful policies in the future.
Dr. Nirainila Joseph: On a clincal perspective, what are the main challenges associated with Candida auris infections? How do they differ from other Candida species in terms of drug resistance and virulence?
Dr. Mary Kiran Danni: Candida auris has certain unique traits. It is difficult to identify using conventional culture techniques which are routinely used in the laboratory. It is intrinsically resistant to Fluconazole, which is usually the first line antifungal prescribed as an empiric therapy in case of suspected fungal infection. Candida auris is also resistant to many commonly used hospital disinfectants and can persist in the hospital environment for weeks, infecting many patients in time. Its virulence is comparable to Candida albicans, which is the most virulent species of Candida so far. Because of all these factors, ICU outbreaks of Candida auris Candidemia are happening all over the world with high mortality rates.
Dr. Nirainila Joseph: Based on your PhD research on Candida auris, what measures do you recommend to prevent the spread of Candida auris in healthcare settings? How can healthcare professionals and institutions implement these measures effectively?
Dr. Mary Kiran Danni: When a case of Candida auris has been identified in a hospital, it can cause persistent infection and also spread to other patients. So, hospitals should be vigilant of this. After such patients get discharged, they should also make sure that cleaning is done using disinfectants that are effective against Candida auris.
Dr. Nirainila Joseph: Moving to the bigger picture, is Candida auris considered a major public health threat? How can public awareness about Candida auris be improved?
Dr. Mary Kiran Danni: There is a hypothesis that Candida auris might have emerged because of the effects of global warming and due to overuse of broad-spectrum antibiotics. People need to be mindful of over the counter medications and refrain from taking antibiotics without a prescription.
Dr. Nirainila Joseph: What are some cutting-edge research areas in fungal microbiology that hold promise for the future?
Dr. Mary Kiran Danni: Compared to bacteriology and virology, medical mycology is still in a nascent stage. Only recently, because of the rise in fungal infections caused by the increase in immunocompromised patients, awareness about fungal infections is improving in the medical community. Fungal taxonomy is itself a big challenge and is being constantly revised in recent times, with the help of molecular techniques. Most of the cutting-edge research in mycology is involved in studying the fungal genome, the various genes responsible for virulence and antifungal resistance. Among clinical studies, major research is happening on rapid bedside tests for identification of fungal infections. Currently, we don't have many of these.
Dr. Nirainila Joseph: Often working behind the scenes in healthcare, microbiologists play a crucial yet sometimes underappreciated role. What do you wish more people knew about the role and impact of microbiologists in science and healthcare?
Dr. Mary Kiran Danni: Doctors in the clinical stream are well aware of the increase in resistant organisms. They have a smaller choice of antibiotics to treat the patients because of this. A microbiologist plays an important role in framing the antimicrobial policy in the hospital which is extremely important to conserve our current store of available antibiotics. The recent Covid-19 pandemic also demonstrated the importance of a microbiologist in establishing diagnostic protocols for a new pathogen in a short period of time.
Dr. Nirainila Joseph: Your insights will give people a better understanding of the critical role microbiologists play in healthcare. now, what advice would you give to medical students or young researchers who are interested in pursuing careers focused on infectious diseases or microbiology?
Dr. Mary Kiran Danni: Microbiology is a lucrative career both for researchers and diagnosticians. Apart from leading the microbiology laboratory, our work entails hospital infection control and antimicrobial policy making as well. Every hospital is looking for an efficient microbiologist who could play all these roles. You can also work in private labs, pharmaceutical companies and research organizations. It will take time to understand what works for you and it is a competitive field. But you will figure out your niche soon!
Dr. Nirainila Joseph: On a personal note, what are your long-term career goals?
Dr. Mary Kiran Danni: As a microbiologist, I love both diagnostics and research. I wish to have a balanced career where I can concentrate on both.
Dr. Nirainila Joseph: When I saw your social media page, it was clear that you have a strong interest in writing blogs and reading a lot of books. How do you balance your time between your demanding career as a microbiologist, Ph.D. study, and your hobbies?
Dr. Mary Kiran Danni: I love reading and writing. Women in the medical field often get carried away by our demanding careers and family obligations. I often feel that, one's hobbies can keep you connected to who you really are amidst all the running in this fast paced world. Writing especially, even if I don't post most of it, helps me understand what's happening inside my head. So I try my best to make some time for that.
Dr. Nirainila Joseph: Your ability to manage your interests while working in such a demanding field is truly impressive. Thank you for sharing your extensive knowledge on microbiology, especially Candida auris, a topic that has become increasingly important due to its growing prevalence. As we wrap up the interview, what would you like the general public to understand about microbial infections and their impact on health?
Dr. Mary Kiran Danni: Not every symptom is an infection. Don't trust your pharmacist and pop antibiotics whenever you get a cold or stomach pain. Only a doctor can diagnose and treat you properly. There are some good microbes in our body as well. Frequently taking antibiotics can affect them and cause disease. Don't trust forwarded messages and compromise on vaccines. Vaccines have and are saving millions of lives.
Not every symptom is an infection. Don't pop antibiotics whenever you get a cold or stomach pain.
MedBound Times expresses sincere gratitude to Dr. Mary Kiran Danni for sharing her valuable insights on our platform.
