MIAMI: Thirteen cases of a sometimes deadly and often drug-resistant fungal infection, Candida auris, have been reported in the United States for the first time, health officials said Friday (Saturday in Manila). The infection, which often spreads in hospitals and other health care settings, can invade the ear canal, urine and bloodstream. Four of the US patients diagnosed with the infection have died, although the precise causes remain unclear, the CDC said. “We need to act now to better understand, contain and stop the spread of this drug-resistant fungus,” the US Centers for Disease Control and Prevention (CDC) Director Tom Frieden said. “This is an emerging threat and we need to protect vulnerable patients and others.” The CDC first identified the fungus as an emerging global threat in June 2016. It was first described in 2009 after being isolated from external ear canal fluids from a patient in Japan, and has since been reported in Britain, Colombia, India, Israel, Kenya, Kuwait, Pakistan, South Africa, South Korea and Venezuela. The report in the CDC’s Morbidity and Mortality Weekly Report (MMWR) described seven of the US cases, which occurred between May 2013 and August 2016.