The New York Times recently published an article calling nursing homes a “breeding ground” for Candida auris, a very contagious fungus that is resistant to most medications. When we hear the word “candida” most of us think of common yeast infections. Candida auris is different.
If you or someone you love lives in a nursing home, you need to know about this deadly fungus and what steps you can take to prevent infection.
What is Candida Auris?
Candida auris is a fungus that was first discovered in Japan over a decade ago. Since 2009, there have been 799 cases reported in the United States. Outbreaks have been reported in healthcare facilities in South America, Asia, and South Africa. The strain of Candida auris in each location has been the same or similar, though symptoms and transmission reports differ slightly.
The fungus does not behave like most, but acts more like a bacteria. It is highly resistant to medications, and spreads quickly. In environments like hospitals and nursing homes, outbreaks happen quickly because the germ spreads fast.
Scientists don’t know where Candida auris originates, as it has only been definitively identified in humans. Centers for Disease Control and Prevention (CDC) officials note that it has to occur somewhere else in nature, but they don’t know where. Scientists also don’t know whether the fungus can infect other species.
It seems that there is a lot more that is not known than what is known. A report in Clinical Infectious Diseases in 2018 noted “simultaneous emergence” of the fungus on three continents. The conclusion of this study lists Candida auris as an “emerging global threat.”
Dr. Luis Otrosky is a professor of infectious diseases at McGovern Medical School at the University of Texas Health Science Center at Houston. He states,
“[the how and why is] the only way we’re going to control it. Because if we don’t know the source, we’re kind of fighting the fire a little bit at a time. If you don’t know the source of an infection, you’re never going to control it completely. And it’s going to keep happening.”
Scientists and Experts Hypothesize Origin
Researchers are considering many hypotheses about where and how Candida auris originates. Some researchers suggest climate change may be a factor in the development of new fungal species. The temperature of the human body serves as a defense to various forms of bacterial and fungal infections. Global warming is being considered as a possible explanation for why certain fungi and bacterium are thriving, and in essence, are adapting.
Researchers at Johns Hopkins Bloomberg School of Public Health state,
“Whether C. auris is the first example of new pathogenic fungi emerging from climate change … its emanation stokes worries that humanity may face new diseases from fungal adaptation to hotter climates.”
Researchers are also concerned about the possible implications of this new germ. Fungi mate sexually and can swap DNA with other fungi. Therefore, Candida auris could potentially mate with other fungi or bacteria and transmit these medication-resistant properties to other infectious germs.
What are the Risks of Candida Auris in Nursing Homes?
What the CDC does know is that Candida auris is a dangerous threat, especially in healthcare settings. The CDC has a dedicated website to Candida auris offering information for healthcare providers and the public. The agency has alerted healthcare providers to be aware of the increasing number of cases, and to take precautions.
Candida auris is most commonly identified in patients in hospitals or nursing homes. More specifically, infections are most common among patients:
- With lengthy hospitalizations
- Who have a central venous catheter
- Who have been intubated or are on a breathing tube
- With a history of antifungal treatment
- With a history of antibiotic treatment
Patients in nursing homes seem to be particularly vulnerable, likely due to the close quarters and shared living spaces. Experts are calling nursing homes “breeding grounds” for infection because of limited staff and poor infection control measures. Nursing homes and hospitals often cycle patients back and forth, which means infected patients are potentially infecting each facility repeatedly.
Betsy McCaughey, former lieutenant governor of New York, says,
“They [nursing homes] are caldrons that are constantly seeding and reseeding hospitals with increasingly dangerous bacteria. You’ll never protect hospital patients until the nursing homes are forced to clean up.”
A Nationwide Problem in Nursing Homes?
In New York, one nursing home reports 38 people infected with Candida auris. In New York State, at least 396 nursing home residents have an active infection. Another 496 carry the germ but don’t have symptoms. The New York Department of Health reports issues with long-term care facilities taking basic infection control measures. Deficiencies include failing to use disposable gowns or gloves, lack of hand sanitizer, and failing to identify infected patients.
In Chicago, the Department of Public Health reports that at least half of all patients in dedicated ventilator units in nursing homes have Candida auris, or are carriers. There are similar reports in other parts of the country.
In California, a recent study shows that 65 percent of nursing home residents in the region studied carried a medication-resistant germ. A startling 80 percent of long-term hospital patients in the same region harbored dangerous germs.
How Does Candida Auris Affect Patients in Nursing Homes?
Like other fungi, Candida auris causes infection. Some patients experience common infections like a urinary tract infection (UTI) or an ear infection. Others experience more severe infections, such as bloodstream infections. The CDC notes that one in three patients with Candida auris experience an invasive form leading to infections of the blood, brain, or heart.
Patients with weakened immune systems may also be more vulnerable to complications of infection like sepsis, which can cause organ failure. This is another factor that requires more research before conclusions can be made.
The mortality rate among patients with invasive Candida auris infection is high. Estimates suggest that as many as 30-60 percent of people with Candida auris infections have died. Doctors and scientists don’t know exactly how the fungus factors into these deaths. Many patients who died suffered other medical conditions or illnesses that could have contributed to their death.
Have Questions or Concerns about Candida Auris in Your Neighborhood?
While New York and Chicago are two cities with numerous infections, Candida auris can develop anywhere. Healthcare facilities in Texas should be vigilant about this fungus and should take infection control very seriously. If you have questions or concerns about Candida auris and a hospital or nursing home in your area, contact your local Health Department to find out more.
You can also contact MedMalFirm.com to find out about your legal rights if you or a loved one is infected with Candida auris. Inadequate infection control is a type of nursing home neglect that should never happen. Was the hospital or nursing home taking adequate infection control measures? Were you unknowingly exposed to someone who carries the fungus? These are important questions that we can certainly help you answer.