Federal health officials are warning about a serious new outbreak, involving an antibiotic-resistant fungal infection which has spread among healthcare facilities in at least two separate cities, causing 123 infections and at least three deaths.
The U.S. Centers for Disease Control and Prevention (CDC) announced the Candida auris outbreak on July 23, advising healthcare professionals about new evidence collected that confirmed the presence of an untreatable fungus spreading across two hospitals in Dallas, Texas and a nursing home in Washington, D.C..
Candida auris is a fungus first seen in Japan in 2009, and it was first identified in the U.S. in 2015. Since it first arrived in the country, the infection has spread dramatically, especially at hospitals and nursing homes.
While C. auris is not typically a threat to most healthy people, those with weakened immune systems can be at an increased risk of life threatening injuries, especially if the infection enters the bloodstream, heart or brain due to the fungi’s resistance to multiple classes of antibiotics.
According to the new warning by CDC officials, from January through April, the Antibiotic Resistance Laboratory Network has detected several independent clusters of pan-resistant or echinocandin-resistant strains of C. auris in Texas and the District of Columbia (DC).
A total of 123 cases have reported across the two states, impacting 22 patients in two Texas hospitals and 101 patients in a DC nursing home facility. Officials reported each cluster involved common health care encounters and no known previous echinocandin exposure, suggesting transmission of pan- and echinocandin-resistant strains for the first time in the United States.
Officials report that of the nursing home fungal infection cases identified in the D.C., three strains of the C. auris infection were resistant to all three kinds of antifungal medications. Two variations of the infection identified in Texas were also completely resistant to current antifungal medications.
CDC officials said it was the first time they have started seeing clusters of resistance “in which patients seemed to be getting the infections from each other.
The agency is warning additional cases have been reported since April, yet those cases have not been totaled in this latest warning. The CDC indicated additional information will be released as it is gathered.
The CDC indicates roughly 30-60% of people who get C. auris die within 90 days. However, many of those with fatal outcomes were already sick with other conditions, which is what made them more susceptible to the infection.
In March 2019, the CDC released a Candida Auris hospital warning, calling the infection a “serious global health threat” to the country, after identifying nearly 600 cases of Candida Auris infections in hospitals, nursing homes and other facilities have been reported in the United States since 2016, raising serious concerns about the emerging health risk linked to the fungus.
Since 2016, the CDC has reported 587 confirmed cases, 30 probable cases, and more than 1,000 people who tested positive for candida auris colonization, meaning the fungus is living on their body but not making them ill.
While most fungal infections respond to echinocandins, a type of anti-fungus medication, candida auris strains are resistant to the main classes of drugs, requiring doctors to treat patients with multiple types of medication at much higher doses or all three classes of drugs at the same time.
The fungus is difficult to prevent the spread in hospital and nursing home facilities due to its ability to act like a bacteria and stick to, and live on, surfaces in healthcare environments, including medical equipment, light switches, mattresses, bed rails, and the hands of doctors and healthcare staff.
Patients can follow certain precautions to prevent candida auris infections, including frequent hand washing and requesting their doctor wash hands before examining them. However, healthcare facilities must change the way they clean and disinfect patient rooms in order to prevent infections from spreading rapidly through hospitals, the CDC warned.
The CDC also recommends patients with C. auris be kept in the same room to prevent spreading it to other patients and to help keep extensive cleaning measures needed following C. auras infection to only certain rooms.